2004 Proposed Final Measure Set

National Healthcare Disparities Report

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In 1999, Congress mandated that the Agency for Healthcare Research and Quality (AHRQ) report annually to the Nation about health care disparities. An interagency workgroup developed the Preliminary Measure Set for the National Healthcare Disparities Report (NHDR). Select for Background on the NHDR preliminary measures.

The NHDR and the National Healthcare Quality Report (NHQR) have been designed and planned as companion reports. To ensure uniformity, these two reports use identical measures of quality of health care to the extent possible with available data. To access the measures of quality of care used in both reports, go to the NHQR Proposed 2004 Final Measure Set.

In addition to examining disparities in quality of health care, the NHDR also examines disparities in access to health care. These Proposed 2004 Final Measures are listed below.

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Contents

Access to Care Measures

Access to the Health Care System
   Health Insurance Coverage / Usual Source of Care / Unmet Need
Structural Barriers Within the System
   Getting Care
Ability of Provider to Address Patient Needs
   Patient-Physician Communication / Patient-Physician Relationship
Health Care Utilization
   Routine and Acute Care / Chronic Care / Avoidable Admissions / Mental Health & Substance Abuse / HIV Care

Access to Care Measures

Access to the Health Care System

Measures		National Databasea	Consensus Processb
Health Insurance Coverage	% of persons with health insurance	NHIS	HP2010
	% of persons with any private insurance coverage	NHIS
	% of persons with only public insurance coverage	NHIS
	% of persons uninsured all year	MEPS
	% of persons with any period of public insurance during a year	MEPS
	% of persons with any period of uninsurance during a year	MEPS
	% of persons offered health insurance coverage through their employer or a family member's employer	MEPS
Usual Source of Care	% of persons who have a specific source of ongoing care	NHIS	HP2010
	% of persons in fair or poor health who have a specific source of ongoing care	NHIS
	% of persons with hospital outpatient department as usual source of care	NHIS
	% of persons with hospital emergency department as usual source of care	NHIS
	Main reason no usual source of healthcare	MEPS
	% of persons with a usual primary care provider	MEPS	HP2010
Unmet Need	% of families that experience difficulties or delays in obtaining health care or do not receive needed care for one or more family members	MEPS	HP2010
	Main problem that caused family member's difficulty, delay, or not receiving needed health care	MEPS
	% of families in which a family member did not receive doctor's care or prescription medications because the family needed the money	MEPS
	Satisfied that your family can get health care if they need it	MEPS

Structural Barriers within the System

Measures		National Databasea	Consensus Processb
Getting Care	Does provider have office hours at night or on weekends?	MEPS
	How difficult is it to get appointment with provider on short notice?	MEPS
	How difficult is it to contact provider over the telephone about a health problem?	MEPS
	How much of a problem was it to get a referral to a specialist that you need to see?	MEPS
	How satisfied with professional staff	MEPS

Ability of Provider to Address Patient Needs

Measures		National Databasea	Consensus Processb
Patient-Physician Communication	Does provider generally listen	MEPS
	Does provider usually ask about prescription medications and treatments other doctors may give	MEPS
	Does provider listen carefully	MEPS
	Does provider explain things	MEPS
	Does provider show respect for what you had to say	MEPS
Patient-Physician Relationship	Satisfied with quality of care received from provider	MEPS
	Are they confident in provider's ability to help when they have a medical problem	MEPS
	Provider spend enough time with you	MEPS

Health Care Utilization

Measures		National Databasea	Consensus Processb
Routine and Acute Care	% of persons with office or outpatient visit	MEPS
	% of persons with prescription medication	MEPS
	% of persons with dental visit	MEPS
	% of persons with emergency room visit	MEPS
	% of persons with inpatient discharge	MEPS
	Outpatient visits per population	National Ambulatory Medical Care Survey / National Hospital Ambulatory Medical Care Survey
	Emergency department visits per population	National Hospital Ambulatory Medical Care Survey
	Total hospitalizations per population	National Hospital Discharge Survey
Chronic Care	% of Medicare beneficiaries 65 and over with Medicare-covered home health care	Medicare Current Beneficiary Survey
	% of Medicare beneficiaries under 65 with Medicare-covered home health care	Medicare Current Beneficiary Survey
	% of Medicare beneficiaries 65 and over with nursing home care in past year	Medicare Current Beneficiary Survey
	% of Medicare beneficiaries under 65 with nursing home care in past year	Medicare Current Beneficiary Survey
Avoidable Admissions	Admissions for hypertension per 100,000 population 18 and older	HCUP
	Admissions for angina per 100,000 population 18 and older	HCUP
	Admissions for chronic obstructive pulmonary disease per 100,000 population 18 and older	HCUP
	Admissions for bacterial pneumonia per 100,000 population	HCUP
	Admissions for perforated appendix per 1,000 admissions with appendicitis	HCUP
Mental Health / Substance Abuse	% of adults who received mental health treatment or counseling in the past year	National Survey on Drug Use and Health
	% of adults who received outpatient mental health treatment or counseling	National Survey on Drug Use and Health
	% of adults who received prescription medications for mental health treatment	National Survey on Drug Use and Health
	% of adults with serious mental illness who received inpatient mental health treatment or counseling	National Survey on Drug Use and Health
	% of adults with serious mental illness who received mental health treatment or counseling	National Survey on Drug Use and Health
	% of persons 12 or older who received illicit drug or alcohol abuse treatment in the past year	National Survey on Drug Use and Health
	% of persons 12 or older who received illicit drug use and who received such treatment in the past year	National Survey on Drug Use and Health
HIV Care	Hospitalizations for HIV per population	National Hospital Discharge Survey
	% of HIV patients with 4+ ambulatory visits in the past year	HIV Research Network
	% of HIV patients with CD4 <50 with 4+ ambulatory visits in the past year	HIV Research Network
	% of HIV patients with inpatient hospitalizations in the past year	HIV Research Network
	% of HIV patients with CD4 <50 with inpatient hospitalization in the past year	HIV Research Network

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[a] AHRQ-PSI, AHRQ-PQI, AHRQ-IQI=AHRQ Quality Indicators (prevention, inpatient and patient safety indicators).
BRFSS=Behavioral Risk Factor Surveillance System.
CDC TB=Centers for Disease Control & Prevention National Tuberclosis Surveillance System.
HCUP=Healthcare Cost and Utilization Project.
HEDIS=Health Plan and Employer Data Information Set.
HP2010=Healthy People 2010.
JCAHO=Joint Commission for Accreditation of Healthcare Organization's hospital core measures.
LHI=Leading Health Indicators.
MEPS=Medical Expenditure Panel Survey.
MDS=Minimum Data Set.
MPSMS=Medicare Patient Safety Monitoring System.
NAMCS=National Ambulatory Medical Care Survey.
NCBD=National CAHPS® Benchmarking Database.
NCQA=National Committee for Quality Assurance' s HEDIS measure set.
NHA=National Health Accounts.
NHANES=National Health and Nutrition Examination Survey.
NHIS=National Health Interview Survey.
NHHCS=National Home Health and Hospice Care Survey.
NHAMCS=National Hospital Ambulatory Medical Care Survey.
NHDS=National Hospital Discharge Survey.
NIS=National Immunization Survey.
NNHS=National Nursing Home Survey.
NQF=National Quality Forum.
OECD=Organization for Economic Cooperation & Development Health Data File.
Vital statistics=National Vital Statistics System, Mortality.
SEER=Surveillance, Epidemiology, and End Results Program.
USRDS=United States Renal Data System.
WHO=World Health Organization.

[b] Measure listed is part of approved final NHQR measure set. However, data were unavailable for the first NHQR.

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Current as of May 2004