2016 National Healthcare Quality and Disparities Report

Appendix B: Trends in Access, Quality and Disparities for Measures in 2016 Report

2016 National Healthcare Quality and Disparities Report

2. Quality of Health Care Through 2014 by Priority Area

Patient Safety

Table Title for Measures Improving Average Annual Percent Change SE P Value Number of Years
Postoperative respiratory failure per 1,000 elective-surgery admissions, age 18 and over -1.43 0.01 0.02 15
(2000-2014)
Postoperative hip fracture per 1,000 surgical admissions who were not susceptible to falling, age 18 and over -2.67 0.01 0.00 15
(2000-2014)
Reclosure of postoperative abdominal wound dehiscence per 1,000 abdominopelvic-surgery admissions of length 2 or more days, age 18 and over -4.46 0.01 0.00 15
(2000-2014)
Adult patients receiving hip joint replacement due to degenerative conditions with adverse events, age 18 and over -8.49 0.03 0.06 6
(2009-2014)
Adult patients receiving hip joint replacement due to fracture with adverse events, age 18 and over -11.09 0.03 0.02 6
(2009-2014)
Home health care patients whose surgical wound was improved, United States -7.65 0.02 0.06 4
(2010- 2013)
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, age 18 and over -2.24 0.01 0.00 15
(2000-2014)
Deaths per 1,000 elective-surgery admissions having developed specified complications of care during hospitalization, ages 18-89 or obstetric admissions -2.03 0.00 0.00 10
(2005-2014)
Deaths per 1,000 hospital admissions with expected low mortality, age 18 and over or obstetric admissions -6.13 0.00 0.00 15
(2000-2014)
Hospital patients who received an anticoagulant who had an adverse drug event with intravenous heparin, age 18 and over -4.59 0.02 0.05 6
(2009-2014)
Hospital patients with an anticoagulant-related adverse drug event to low-molecular-weight heparin and factor Xa, age 18 and over -9.29 0.02 0.01 6
(2009-2014)
Hospital patients who received a hypoglycemic agent who had an adverse drug event with hypoglycemic agents, age 18 and over -5.88 0.01 0.01 6
(2009-2014)
Home health care patients who get better at taking their medication correctly -3.40 0.00 0.01 4
(2010-2013)
Birth trauma-injury to neonate per 1,000 live births -5.82 0.01 0.00 14
(2001-2014)
Obstetric trauma per 1,000 vaginal deliveries without instrument assistance -4.90 0.00 0.00 15
(2000-2014)
Obstetric trauma per 1,000 instrument-assisted vaginal deliveries -3.35 0.00 0.00 15
(2000-2014)
Adults age 65 and over who received in the calendar year at least 1 of 11 prescription medications that should be avoided in older adults -6.41 0.01 0.00 13
(2002-2014)
Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults 4.27 0.00 0.00 13
(2002-2014)

 

Table Title for Measures Showing No Change Average Annual Percent Change SE P Value Number of Years
Postoperative sepsis per 1,000 elective-surgery admissions of length 4 or more days, age 18 and over -0.82 0.02 0.62 7
(2008-2014)
Adult surgery patients with postoperative pneumonia events, age 18 and over -3.51 0.03 0.27 6
(2009-2014)
Postoperative hemorrhage or hematoma with surgical drainage or evacuation per 1,000 surgical admissions, age 18 and over -0.09 0.00 0.70 15
(2000-2014)
Adult patients receiving knee replacement with adverse events, age 18 and over -10.12 0.06 0.17 6
(2009-2014)
Bloodstream infection in adult patients receiving central venous catheter placement, age 18 and over -4.05 0.06 0.57 4
(2009-2012)
Mechanical adverse events in adult patients receiving central venous catheter placement, age 18 and over -2.90 0.02 0.20 6
(2009-2014)
Hospital admissions with accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, age <18 years -1.17 0.01 0.11 15
(2000-2014)
Hospital admissions with iatrogenic pneumothorax per 1,000 medical and surgical admissions, age 18 and over -0.95 0.01 0.14 15
(2000-2014)
Hospital patients with an anticoagulant-related adverse drug event to warfarin, age 18 and over 0.16 0.03 0.96 6
(2009-2014)

 

Table Title for Measures Worsening Average Annual Percent Change SE P Value Number of Years
Adult surgery patients with postoperative venous thromboembolic events, age 18 and over 8.10 0.03 0.05 6
(2009-2014)
Postoperative physiologic and metabolic derangements per 1,000 elective-surgery admissions, age 18 and over 1.60 0.01 0.01 15
(2000-2014)

Person-Centered Care

Table Title for Measures Improving Average Annual Percent Change SE P Value Number of Years
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never listened carefully to them -2.51 0.00 0.00 13
(2002-2014)
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never explained things in a way they could understand -3.87 0.01 0.00 13
(2002-2014)
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never showed respect for what they had to say -3.29 0.01 0.00 13
(2002-2014)
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never spent enough time with them -3.42 0.00 0.00 13
(2002-2014)
Rating of health care 0-6 on a scale from 0 to 10 (best grade) by adults who had a doctor's office or clinic visit in the last 12 months -2.29 0.00 0.00 13
(2002-2014)
People with a usual source of care who sometimes or never asked person to help make decisions when there was a choice between treatments -2.96 0.01 0.00 13
(2002-2014)
Adult hospital patients who sometimes or never had good communication about medications they received in the hospital -4.34 0.01 0.00 7
(2009-2015)
Hospice patient caregivers who perceived patient was referred to hospice at the right time -2.48 0.00 0.00 7
(2008-2014)
Hospice patients who received care consistent with their stated end-of-life wishes -1.69 0.00 0.01 7
(2008-2014)

 

Table Title for Measures Showing No Change Average Annual Percent Change SE P Value Number of Years
Hospice patients who received the right amount of help for feelings of anxiety or sadness -0.488 0.1 Not calculated 7
(2008-2014)
Family caregivers who did not want more information about what to expect while the patient was dying -0.669 0.1 Not calculated 7
(2008-2014)

Healthy Living

Table Title for Measures Improving Average Annual Percent Change SE P Value Number of Years
Infant mortality per 1,000 live births, birth weights >2,499 grams -1.35 0.00 0.00 13
(2001-2013)
Infants who received breastfeeding through 3 months -4.18 0.01 0.02 4
(2009-2012)
Adult current smokers with a checkup in the last 12 months who received advice to quit smoking -1.08 0.00 0.00 13
(2002-2014)
Children ages 2-19 with obesity who had been told by a doctor or health professional that they were overweight -1.72 0.00 0.01 4
(1999-2002, 2003-2006, 2007-2010, 2011-2014)
Adults with obesity who ever received advice from a health professional to exercise more -1.24 0.00 0.00 13
(2002-2014)
Children ages 2-17 for whom a health provider gave advice within the past 2 years about the amount and kind of exercise, sports, or physically active hobbies they should have -1.89 0.00 0.00 13
(2002-2014)
Children ages 2-17 for whom a health provider gave advice within the past 2 years about healthy eating -2.19 0.00 0.00 13
(2002-2014)
Home health care patients who get better at walking or moving around -5.79 0.00 0.00 4
(2010-2013)
Home health care patients who get better at getting in and out of bed -2.88 0.00 0.01 4
(2010-2013)
Home health care patients who get better at bathing -3.75 0.00 0.00 4
(2010-2013)
Home health care patients who have less shortness of breath -2.53 0.00 0.01 4
(2010-2013)
Home health care patients who stayed at home after an episode of home health care ended -2.21 0.00 0.03 4
(2010-2013)
Home health care patients who have less pain when moving around -2.07 0.00 0.01 4
(2010-2013)
Cervical cancer diagnosed at advanced stage per 100,000 women age 20 and over -1.75 0.00 0.00 14
(2000-2013)
Colorectal cancer diagnosed at advanced stage per 100,000 men and women age 50 and over -3.64 0.00 0.00 14
(2000-2013)
Adults who received a blood cholesterol measurement in the last 5 years -4.72 0.01 0.06 4
(1998, 2003, 2008, 2014)
Adults age 18 and over who received an influenza vaccination in the past 12 months -2.65 0.00 0.01 5
(2010-2014)
Adults age 65 and over who received an influenza vaccination in the last 12 months -1.36 0.01 0.06 13
(2002-2014)
Adults age 65 and over who ever received pneumococcal vaccination -1.32 0.00 0.00 15
(2000-2014)
Children ages 19-35 months who received 3 or more doses of polio vaccine -3.03 0.01 0.00 14
(2001-2014)
Children ages 19-35 months who received 1 or more doses of varicella vaccine -6.11 0.01 0.00 14
(2001-2014)
Adolescents ages 13-15 years who received 1 or more doses of meningococcal conjugate vaccine -15.60 0.01 0.00 7
(2008-2014)
Adolescents ages 16-17 years who received 1 or more doses of meningococcal conjugate vaccine -16.94 0.01 0.00 7
(2008-2014
Adolescent females ages 13-15 years who received 3 or more doses of human papillomavirus vaccine -3.46 0.01 0.00 7
(2008-2014
Adolescent females ages 16-17 years who received 3 or more doses of human papillomavirus vaccine -6.11 0.01 0.00 7
(2008-2014

 

Table Title for Measures Improving Average Annual Percent Change SE P Value Number of Years
Adolescents ages 13-15 years who received 1 or more doses of tetanus-diphtheria-acellular pertussis (Tdap) vaccine -23.02 0.02 0.00 7
(2008-2014
Adolescents ages 16-17 years who received 1 or more doses of tetanus-diphtheria-acellular pertussis (Tdap) vaccine -25.35 0.03 0.00 7
(2008-2014
Children ages 6 months to 17 years who received influenza vaccination in the past 12 months -4.58 0.01 0.01 5
(2010-2014)
Children who had their height and weight measured by a health provider within the past 2 years -5.08 0.01 0.00 13
(2002-2014)
Children ages 3-5 who ever had their vision checked by a health provider -2.41 0.00 0.00 13
(2002-2014)
Children 0-40 lbs for whom a health provider gave advice within the past 2 years about using a child safety seat while riding in the car -1.20 0.00 0.01 13
(2002-2014)
Children 41-80 lbs for whom a health provider gave advice within the past 2 years about using a booster seat when riding in the car -1.33 0.00 0.00 13
(2002-2014)
Children ages 0-17 who had a wellness checkup in the last 12 months -3.30 0.01 0.00 17
(2000-2014)

 

Table Title for Measures Showing No Change Average Annual Percent Change SE P Value Number of Years
Live-born infants with low birth weight (<2,500 grams) -0.44 0.00 0.00 8
(2007-2014)
Adults age 20 and over with obesity who had been told by a doctor or health professional that they were overweight -0.23 0.01 0.75 4
(2002, 2006, 2010, 2014)
Children ages 2-5 with obesity -1.94 0.02 0.28 5
(2002, 2006, 2010, 2012, 2014)
Children ages 6-11 with obesity 0.97 0.01 0.16 5
(2002, 2006, 2010, 2012, 2014)
Adults with obesity who ever received advice from a health professional about eating fewer high-fat or high-cholesterol foods -0.57 0.00 0.00 13
(2002-2014)
Breast cancer diagnosed at advanced stage per 100,000 women age 40 and over -0.53 0.00 0.00 14
(2000-2013)
Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high -1.03 0.01 0.40 5
(2003, 2008, 2012, 2014)
Adults ages 18-64 at high risk (e.g., COPD) who received an influenza vaccination in the past 12 months -1.73 0.01 0.17 5
(2010-2014)
Hospital admissions for immunization-preventable influenza per 100,000 population, age 65 and over 5.25 0.04 0.26 15
(2000-2014)
Adults ages 18-64 at high risk (e.g., COPD) who ever received pneumococcal vaccination -0.67 0.00 0.00 15
(2000-2014)
Children ages 19-35 months who received 4 or more doses of diphtheria-tetanus-pertussis vaccine -0.04 0.01 0.94 14
(2001-2014)
Children ages 19-35 months who received 1 or more doses of measles-mumps-rubella vaccine 0.89 0.01 0.18 14
(2001-2014)
Children ages 19-35 months who received 3 or more doses of hepatitis B vaccine 0.05 0.01 0.97 14
(2001-2014)

 

Table Title for Measures Showing No Change Average Annual Percent Change SE P Value Number of Years
Children ages 2-17 who had a dental visit in the calendar year -0.51 0.00 0.03 13
(2002-2014)
Children for whom a health provider gave advice within the past 2 years about how smoking in the house can be bad for a child -0.26 0.00 0.22 13
(2002-2014)
Children over 80 lb for whom a health provider gave advice within the past 2 years about using lap or shoulder belts when riding in a car -0.84 0.00 0.00 13
(2002-2014)
Children ages 2-17 for whom a health provider gave advice within the past 2 years about using a helmet when riding a bicycle or motorcycle -0.41 0.00 0.02 13
(2002-2014)

 

Table Title for Measures Worsening Average Annual Percent Change SE P Value Number of Years
Children ages 12-19 with obesity 2.15 0.00 0.01 5
(2002, 2006, 2010, 2012, 2014)
Home health care patients who have less urinary incontinence 1.08 0.00 0.05 4
(2010-2013)
Women ages 50-74 who received a mammogram in the last 2 years 1.37 0.01 0.06 6
(2000, 2003, 2005, 2008, 2010, 2013)
Women ages 21-65 who received a Pap smear in the last 3 years 3.32 0.00 0.00 5
(2000, 2005, 2008, 2010, 2013)

Effective Treatment

Table Title for Measures Improving Average Annual Percent Change SE P Value Number of Years
Women with clinical Stage I-IIb breast cancer who received axillary node dissection or sentinel lymph node biopsy at the time of surgery (lumpectomy or mastectomy) -7.95 0.01 0.00 10
(2004-2013)
Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis -7.15 0.01 0.00 10
(2004-2013)
Breast cancer deaths per 100,000 female population per year -1.86 0.00 0.00 15
(2000-2014)
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined -15.84 0.01 0.00 10
(2004-2013)
Colorectal cancer deaths per 100,000 population per year -2.59 0.00 0.00 15
(2000-2014)
Lung cancer deaths per 100,000 population per year -2.00 0.00 0.00 15
(2000-2014)
Adults with hypertension with blood pressure less than 140/90 mm/Hg -3.00 0.01 0.02 5
(2002, 2006, 2010, 2012, 2014)
Deaths per 1,000 hospital admissions with acute myocardial infarction, age 18 and over -6.31 0.00 0.00 15
(2000-2014)
Acute myocardial infarction patients who received fibrinolytic medication within 30 minutes of arrival -4.60 0.01 0.00 10
(2005-2014)
Hospital admissions for heart failure per 100,000 population, age 18 and over -3.71 0.00 0.00 15
(2000-2014)
Deaths per 1,000 hospital admissions with congestive heart failure, age 18 and over -9.05 0.00 0.00 15
(2000-2014)
Deaths per 1,000 hospital admissions with abdominal aortic aneurysm repair, age 18 and over -4.26 0.00 0.00 15
(2000-2014)
Deaths per 1,000 hospital admissions with coronary artery bypass graft, age 40 and over -8.10 0.00 0.00 15
(2000-2014)
Deaths per 1,000 hospital admissions with percutaneous coronary intervention, age 40 and over -3.95 0.00 0.00 15
(2000-2014)
End stage renal disease patients age 18 and over who saw a nephrologist at least 12 months prior to initiation of renal replacement therapy -1.52 0.00 0.00 10
(2005-2014)
Adults age 40 and over with diagnosed diabetes with total cholesterol less than 200 mg/dL -4.67 0.01 0.03 4
(2002, 2006, 2010, 2012)
HIV infection deaths per 100,000 population -7.26 0.00 0.00 15
(2000-2014)
Deaths per 1,000 hospital admissions with pneumonia, age 18 and over -9.25 0.00 0.00 15
(2000-2014)
Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment -4.89 0.01 0.00 13
(2000-2012)

 

Table Title for Measures Showing No Change Average Annual Percent Change SE P Value Number of Years
Dialysis patients under age 70 who were registered on a waiting list for transplantation within a year of initiation -0.28 0.00 0.00 15
(2000-2014)
Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure 0.61 0.00 0.00 12
(2000-2011)
Adults age 40 and over with diagnosed diabetes who received 2 or more hemoglobin A1c measurements in the calendar year 0.79 0.01 0.30 13
(2002-2014)

 

Table Title for Measures Showing No Change Average Annual Percent Change SE P Value Number of Years
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year -0.19 0.00 0.53 13
(2002-2014)
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year 1.10 0.01 0.11 13
(2002-2014)
Adults age 40 and over with diagnosed diabetes who received a flu vaccination in the calendar year -1.00 0.01 0.34 7
(2008-2014)
Adults age 40 and over with diabetes whose condition was diagnosed -2.54 0.01 0.11 4
(2002, 2006, 2010, 2014)
Adults age 40 and over with diagnosed diabetes with blood pressure less than 130/80 mm Hg -1.82 0.01 0.15 4
(2002, 2006, 2010, 2014)
Adjusted incident rates of end stage renal disease due to diabetes per million population -0.96 0.00 0.00 14
(2001-2014)
Adults with a major depressive episode in the last 12 months who received treatment -0.52 0.01 0.46 8
(2008-2015)
Children ages 12-17 with a major depressive episode in the last 12 months who received treatment -0.83 0.00 0.06 8
(2008-2015)
People age 12 and over who needed treatment for illicit drug use and who received such treatment at a specialty facility in the last 12 months -0.27 0.00 0.04 14
(2002-2015)
People age 12 and over who needed treatment for an alcohol problem and who received such treatment at a specialty facility in the last 12 months -0.05 0.00 0.10 14
(2002-2015)
Number of discharges from substance abuse treatment for persons age 12 and over and percent who completed treatment -0.03 0.01 0.96 8
(2005-2012)
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms -1.23 0.01 0.24 6
(2009-(2014)

 

Table Title for Measures Worsening Average Annual Percent Change SE P Value Number of Years
Suicide deaths per 100,000 population 3.13 0.00 0.00 15
(2000-2014)
People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler) 1.10 0.00 0.00 12
(2003-2014)

Care Coordination

Table Title for Measures Improving Average Annual Percent Change SE P Value Number of Years
Hospital patients with heart failure who were given complete written discharge instructions -23.07 0.01 0.00 9
(2005-2013)
Adult hospital patients who did not receive good communication about discharge information -6.21 0.00 0.00 7
(2009-2015)
People with a usual source of care who usually asks about prescription medications and treatments from other doctors -2.21 0.01 0.00 13
(2002-2014)
Hospital admissions for uncontrolled diabetes without complications per 100,000 population, age 18 and over -4.14 0.01 0.00 15
(2000-2014)
Lower extremity amputations among admissions for diabetes per 100,000 population, age 18 and over -2.54 0.01 0.00 15
(2000-2014)
Hospital admissions for asthma per 100,000 population, ages 18 to 39 -3.58 0.00 0.00 15
(2000-2014)
Hospital admissions for asthma per 100,000 population, ages 2-17 -2.91 0.01 0.00 15
(2000-2014)
Emergency department visits for congestive heart failure per 100,000 population (including inpatient admissions), age 18 and over -1.71 0.01 0.04 7
(2008-2014)
Home health care patients who had to be admitted to the hospital -2.45 0.01 0.04 4
(2010-2013)
Hospital admissions for dehydration per 100,000 population, age 18 and over -4.68 0.01 0.00 15
(2000-2014)
Admissions for angina without cardiac procedure per 100,000 population, age 18 and over -13.17 0.00 0.00 15
(2000-2014)
Hospital admissions with chronic obstructive pulmonary disease or asthma per 100,000 population, age 40 and over -1.81 0.01 0.05 10
(2005-2014)
Hospital admissions for bacterial pneumonia per 100,000 population, age 18 and over -3.82 0.00 0.00 15
(2000-2014)
Hospital admissions for urinary tract infection per 100,000 population, ages 3 months to 17 years -4.24 0.01 0.00 15
(2000-2014)
Hospital admissions for pediatric gastroenteritis per 100,000 population, ages 3 months to 17 years -11.07 0.01 0.00 15
(2000-2014)

 

Table Title for Measures Showing No Change Average Annual Percent Change SE P Value Number of Years
Emergency department visits for asthma per 100,000 population (including inpatient admissions), ages 18-39 0.42 0.01 0.48 7
(2008-2014)
Children ages 2-19 with hospital emergency department visit for asthma per 10,000 population 0.88 0.02 0.69 5
(2008-2012)
Hospital admissions with diabetes with short-term complications per 100,000 population, ages 6-17 -1.05 0.01 0.11 15
(2000-2014)
Hospital admissions with diabetes with long-term complications per 100,000 population, age 18 and over -0.69 0.00 0.01 15
(2000-2014)
Home health care patients who had an emergency department visit and were then hospitalized 0.29 0.01 0.71 4
(2010-2013)
Hospital admissions with perforations or abscesses of appendix per 1,000 admissions with appendicitis, age 18 and over 0.09 0.00 0.83 15
(2000-2014)
Home health care patients who needed urgent, unplanned medical care -0.33 0.00 0.47 4
(2010-2013)
Hospital admissions for urinary tract infection per 100,000 population, age 18 and over 0.96 0.00 0.02 15
(2000-2014)

 

Table Title for Measures Worsening Average Annual Percent Change SE P Value Number of Years
Emergency department visits with a principal diagnosis related to mental health only per 100,000 population 3.21 0.00 0.00 8
(2007-2014)
Emergency department visits with a principal diagnosis related to substance abuse only per 100,000 population 5.14 0.00 0.00 8
(2007-2014)
Emergency department visits with a principal diagnosis related to co-occurring mental health, alcohol, and substance abuse per 100,000 population 5.29 0.01 0.00 8
(2007-2014)
Emergency department visits with a principal diagnosis related to dental conditions per 100,000 population 1.38 0.01 0.06 6
(2009-2014)
Emergency department visits for asthma per 100,000 population (including inpatient admissions), ages 2-17 1.84 0.01 0.08 7
(2008-2014)
Hospital admissions with diabetes with short-term complications per 100,000 population, age 18 and over 3.52 0.00 0.00 15
(2000-2014)
Hospital admissions with perforations or abscesses of appendix per 1,000 admissions with appendicitis, ages 1-17 1.32 0.00 0.01 15
(2000-2014)
Avoidable admissions for hypertension per 100,000 population age 18 and over 1.91 0.01 0.00 15
(2000-2014)

 

Page last reviewed July 2017
Page originally created June 2017
Internet Citation: Appendix B: Trends in Access, Quality and Disparities for Measures in 2016 Report. Content last reviewed July 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqdr16/appendixb2_qualitytrends.html