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National Healthcare Disparities Report, 2006

Health Care Utilization

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General Medical Care
People with an office-based or outpatient department visit in the past year
People with a prescription medication in the past year
People with a dental visit in the past year
People with an emergency room visit in the past year
People with an inpatient discharge in the past year
Outpatient visits per 100 population
Emergency department visits per 100 population
Hospitalizations per 100 population
Avoidable Admissions
Avoidable admissions for hypertension per 100,000 population age 18+
Avoidable admissions for angina per 100,000 population age 18+
Avoidable admissions for chronic obstructive pulmonary disease per 100,000 population age 18+
Avoidable admissions for bacterial pneumonia per 100,000 population
Perforated appendices per 1,000 admissions with appendicitis
Mental Health Care and Substance Abuse Treatment
Adults who received mental health treatment or counseling in the past year
Adults who received outpatient mental health treatment or counseling
Adults who received prescription medications for mental health treatment
Adults who received inpatient mental health treatment or counseling
People age 12 and older who received illicit drug or alcohol abuse treatment in the past year
Ambulatory Care
Outpatient visits where the patient was seen before in a clinic or practice
Outpatient visits where the patient was seen by the patient's primary care provider
Outpatient visits where the patient was seen for non-illness care
Outpatient visits with counseling or education about diet and nutrition
Outpatient visits with counseling or education about exercise
Outpatient visits with counseling or education about tobacco use and exposure
Outpatient visits where the physician spent more than 30 minutes with the patient
Referred Care
Outpatient visits where the patient was referred by another physician or health plan
Outpatient visits where the patient was referred to another physician
Emergency Care
Emergency department visits related to injury per 10,000 population
Emergency department visits for asthma per 10,000 population
Emergency department visits where the patient was seen by an intern/resident only

General Medical Care

Measure Title

People with an office-based or outpatient department visit in the past year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

216. People with an office or outpatient visit, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized population.

Numerator

U.S. civilian noninstitutionalized population who reported at least 1 office-based/outpatient department visit.

Comments

Office-based/outpatient department visits include:

Office-based visits (physician and nonphysician)
Outpatient department visits (physician and nonphysician)
Inpatient visits where the admission date was the same as the discharge date (i.e., "zero-night" stays)

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General Medical Care

Measure Title

People with a prescription medication in the past year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

217. People with prescription medication, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized population.

Numerator

U.S. civilian noninstitutionalized population who reported at least 1 prescribed medication.

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General Medical Care

Measure Title

People with a dental visit in the past year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

218. People with a dental visit, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized population.

Numerator

U.S. civilian noninstitutionalized population who reported at least 1 dental visit.

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General Medical Care

Measure Title

People with an emergency room visit in the past year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

219. People with an emergency room visit, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized population.

Numerator

U.S. civilian noninstitutionalized population who reported at least 1 emergency room visit.

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General Medical Care

Measure Title

People with an inpatient discharge in the past year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

220. People with an inpatient discharge, United States, 2003, by

Race
Ethnicity
Family income
Education

Data Source

AHRQ, MEPS.

Denominator

U.S. civilian noninstitutionalized population.

Numerator

U.S. civilian noninstitutionalized population who reported at least 1 inpatient discharge.

Comments

Inpatient discharges exclude inpatient visits where the admission date was the same as the discharge date (i.e., "zero-night" stays).

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General Medical Care

Measure Title

Outpatient visits per 100 population.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

221. Outpatient visits per 100 population, United States, 2003-2004, by

Race

Data Source

CDC, NCHS, National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS)—Outpatient Departments.

Denominator

U.S. civilian population.

Numerator

Number of visits to office-based physicians and hospital outpatient departments.

Comments

Estimates of the civilian noninstitutionalized population are from special tabulations developed by the Population Division, U.S. Census Bureau, using the July 1, 2001 and July 1, 2002 set of State population estimates, and reflect Census 2000 data.Year 2001 rates use U.S. Bureau of the Census estimates of the civilian noninstitutionalized population as of July 1, 2001 and are based on data from Census 2000.

Estimates of metropolitan and nonmetropolitan statistical areas used in calculating visit rates are preliminary figures based on Census 2000 data and were obtained through the Office of Research and Methodology and Division of Health Interview Statistics, NCHS. They are based on U.S. Census Bureau estimates of the civilian noninstitutional population of the United States as of July 1, 2003 and July 1, 2004.

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General Medical Care

Measure Title

Emergency department visits per 100 population.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

222. Emergency department visits per 100 population, United States, 2003-2004, by

Race

Data Source

CDC, NCHS, National Hospital Ambulatory Medical Care Survey (NHAMCS)—Emergency Departments.

Denominator

U.S. civilian population.

Numerator

Number of visits to hospital emergency departments.

Comments

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General Medical Care

Measure Title

Hospitalizations per 100 population.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

223. Hospitalizations per 100 population, United States, 2004, by

Race

Data Source

CDC, NCHS, National Hospital Discharge Survey (NHDS).

Denominator

U.S. civilian population.

Numerator

Number of hospitalizations.

Comments

Rates were computed using estimates of the civilian population of the United States as of July 1, 2002, based on the 2000 census.

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Avoidable Admissions

Measure Title

Avoidable admissions for hypertension per 100,000 population age 18 and older.

Measure Source

Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators.

Table

224. Admissions for hypertension (excluding patients with cardiac procedures, obstetric and neonatal conditions, and transfers from other institutions) per 100,000 population, age 18 years and older, United States, 2003, by

Race/ethnicity

Data Source

AHRQ, Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases, disparities analysis file.

Denominator

Adult U.S. population age 18 and older by subcategory (i.e., race, age group, gender, median household income level, urbanization, and region).

Numerator

Adult non-maternal discharges age 18 and over with principal diagnosis of hypertension, excluding patients with cardiac procedures and transfers from other institutions.

Comments

Rates are adjusted by age and gender using the total U.S. population for 2000 as the standard population. When reporting is by age, the adjustment is by gender only; when reporting is by gender, the adjustment is by age only.

The disparities analysis file, created specifically for this report to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 23 States that participate in HCUP and have high-quality race/ethnicity data: AZ, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, PA, RI, SC, TN, TX, VA, VT, and WI.

This table was created using version 2.1, release 2, of the AHRQ Prevention Quality Indicators software. This measure is referred to as indicator 7 in the AHRQ Prevention Quality Indicators software documentation.

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Avoidable Admissions

Measure Title

Avoidable admissions for angina per 100,000 population age 18 and older.

Measure Source

Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators.

Table

225. Admissions for angina without procedure (excluding patients with cardiac procedures, transfers from other institutions, and obstetric and neonatal admissions) per 100,000 population, age 18 years and older, United States, 2003, by

Race/ethnicity

Data Source

AHRQ, Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases, disparities analysis file.

Denominator

Adult U.S. population age 18 and older by subcategory (i.e., race, age group, gender, median household income level, urbanization, and region).

Numerator

Adult non-maternal discharges age 18 and over with principal diagnosis of angina, excluding patients with cardiac procedures and transfers from other institutions.

Comments

This table was created using version 2.1, release 2, of the AHRQ Prevention Quality Indicators software. This measure is referred to as indicator 13 in the AHRQ Prevention Quality Indicators software documentation.

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Avoidable Admissions

Measure Title

Avoidable admissions for chronic obstructive pulmonary disease per 100,000 population age 18 and older.

Measure Source

Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators.

Table

226. Admissions for chronic obstructive pulmonary disease (COPD) (excluding obstetric admissions and transfers from other institutions) per 100,000 population, age 18 years and older, United States, 2003, by

Race/ethnicity

Data Source

AHRQ, Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases, disparities analysis file.

Denominator

Adult U.S. population age 18 and older by subcategory (i.e., race, age group, gender, median household income level, urbanization, and region).

Numerator

Adult non-maternal discharges age 18 and over with principal diagnosis of chronic obstructive pulmonary disease (COPD), excluding transfers from other institutions.

Comments

This table was created using version 2.1, release 2, of the AHRQ Prevention Quality Indicators software. This measure is referred to as indicator 5 in the AHRQ Prevention Quality Indicators software documentation.

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Avoidable Admissions

Measure Title

Avoidable admissions for bacterial pneumonia per 100,000 population.

Measure Source

Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators.

Table

227. Bacterial pneumonia admissions (excluding sickle cell or hemoglobin-S conditions, transfers from other institutions, and obstetric and neonatal admissions) per 100,000 population, United States, 2003, by

Race/ethnicity

Data Source

AHRQ, Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases, disparities analysis file.

Denominator

Adult U.S. population age 18 and older by subcategory (i.e., race, age group, gender, median household income level, urbanization, and region).

Numerator

Non-maternal/non-neonatal discharges with principal diagnosis of bacterial pneumonia, excluding sickle cell or hemoglobin-S conditions and transfers from other institutions.

Comments

This table was created using version 2.1, release 2, of the AHRQ Prevention Quality Indicators software. This measure is referred to as indicator 11 in the AHRQ Prevention Quality Indicators software documentation.

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Avoidable Admissions

Measure Title

Perforated appendices per 1,000 admissions with appendicitis.

Measure Source

Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators.

Table

228. Admissions with perforated appendix per 1,000 admissions with appendicitis (excluding obstetric and neonatal admissions and transfers from other institutions), United States, 2003, by

Race/ethnicity

Data Source

AHRQ, Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases, disparities analysis file.

Denominator

Non-maternal/non-neonatal discharges with principal or secondary diagnosis of appendicitis, excluding transfer from other institutions.

Numerator

Subset of the denominator with principal or secondary diagnosis code for perforation or abscess of appendix.

Comments

Rates are adjusted by age and gender using the total U.S. inpatient population for 2000 as the standard population. When reporting is by age, the adjustment is by gender only; when reporting is by gender, the adjustment is by age only.

This table was created using version 2.1, release 2, of the AHRQ Prevention Quality Indicators software. This measure is referred to as indicator 2 in the AHRQ Prevention Quality Indicators software documentation.

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Mental Health Care and Substance Abuse Treatment

Measure Title

Adults who received mental health treatment or counseling in the past year.

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA).

Tables

229. Adults age 18 and over who received mental health treatment or counseling in the past year, United States, 2004, by

Race
Ethnicity
Family income
Education

Data Source

SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).

Denominator

Persons age 18 or older.

Numerator

Persons age 18 or older who reported receipt of mental health treatment or counseling in the past year.

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Mental Health Care and Substance Abuse Treatment

Measure Title

Adults who received outpatient mental health treatment or counseling.

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA).

Tables

230. Adults age 18 and over who received outpatient mental health treatment or counseling in the past year, United States, 2004, by

Race
Ethnicity
Family income
Education

Data Source

SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).

Denominator

Persons age 18 or older.

Numerator

Persons age 18 or older who reported receipt of outpatient mental health treatment or counseling in the past year.

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Mental Health Care and Substance Abuse Treatment

Measure Title

Adults who received prescription medications for mental health treatment.

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA).

Tables

231. Adults age 18 and over who received prescription medications for mental health treatment or counseling in the past year, United States, 2004, by

Race
Ethnicity
Family income
Education

Data Source

SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).

Denominator

Persons age 18 or older.

Numerator

Persons age 18 or older who reported receipt of prescription medications for mental health treatment or counseling in the past year.

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Mental Health Care and Substance Abuse Treatment

Measure Title

Adults who received inpatient mental health treatment or counseling.

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA).

Tables

232. Adults age 18 and over who received inpatient mental health treatment or counseling in the past year, United States, 2004, by

Race
Ethnicity
Family income
Education

Data Source

SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).

Denominator

Persons age 18 or older.

Numerator

Persons age 18 or older who reported receipt of inpatient mental health treatment or counseling in the past year.

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Mental Health Care and Substance Abuse Treatment

Measure Title

People age 12 and older who received illicit drug or alcohol abuse treatment in the past year.

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA).

Tables

233. Persons age 12 and over who received any illicit drug or alcohol abuse treatment in the past year, United States, 2004, by

Race
Ethnicity
Family income
Education

Data Source

SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).

Denominator

Persons age 12 or older.

Numerator

Persons age 12 or older who received any illicit drug or alcohol abuse treatment in the past year.

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Ambulatory Care

Measure Title

Outpatient visits where the patient was seen before in a clinic or practice.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

234. Outpatient visits where patient was seen before in hospital clinic or office-based practice, United States, 2003-2004, by

Race

Data Source

CDC, NCHS, National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS)—Outpatient Departments.

Denominator

Number of visits to office-based physicians and hospital outpatient departments.

Numerator

Number of visits to office-based physicians and hospital outpatient departments where patient was seen before in a clinic or practice.

Comments

The NAMCS/NHAMCS question is "has patient been seen in this clinic before?" or "have you or anyone in your practice/department seen patient before?"

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Ambulatory Care

Measure Title

Outpatient visits where the patient was seen by the patient's primary care provider.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

235. Outpatient visits where the patient was seen by the patient's primary care provider, United States, 2003-2004, by

Race

Data Source

CDC, NCHS, National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS)—Outpatient Departments.

Denominator

Number of visits to office-based physicians and hospital outpatient departments.

Numerator

Number of visits to office-based physicians and hospital outpatient departments where the patient was seen by the patient's primary care provider.

Comments

The NAMCS/NHAMCS question is "Are you the patient's primary care physician?"

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Ambulatory Care

Measure Title

Outpatient visits where the patient was seen for non-illness care.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

236. Outpatient visits where the patient was seen for non-illness care, United States, 2003-2004, by

Race

Data Source

CDC, NCHS, National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS)—Outpatient Departments.

Denominator

Number of visits to office-based physicians and hospital outpatient departments.

Numerator

Number of visits to office-based physicians and hospital outpatient departments where the patient was seen for non-illness care.

Comments

The NAMCS/NHAMCS question is "Major reason for this visit" with response "Non-illness care (e.g., routine, prenatal, general exam., well baby)."

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Ambulatory Care

Measure Title

Outpatient visits with counseling or education about diet and nutrition.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

237. Outpatient visits with counseling or education about diet and nutrition, United States, 2003-2004, by

Race

Data Source

CDC, NCHS, National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS)—Outpatient Departments.

Denominator

Number of visits to office-based physicians and hospital outpatient departments.

Numerator

Number of visits to office-based physicians and hospital outpatient departments with counseling or education about diet and nutrition.

Comments

The NAMCS/NHAMCS question is "Therapeutic and preventive services ordered or provided at this visit" with response "Counseling/education: diet/nutrition."

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Ambulatory Care

Measure Title

Outpatient visits with counseling or education about exercise.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

238. Outpatient visits with counseling or education about exercise, United States, 2003-2004, by

Race

Data Source

CDC, NCHS, National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS)—Outpatient Departments.

Denominator

Number of visits to office-based physicians and hospital outpatient departments.

Numerator

Number of visits to office-based physicians and hospital outpatient departments with counseling or education about exercise.

Comments

The NAMCS/NHAMCS question is "Therapeutic and preventive services ordered or provided at this visit" with response "Counseling/education: exercise."

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Ambulatory Care

Measure Title

Outpatient visits with counseling or education about tobacco use and exposure.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

239. Outpatient visits with counseling or education about tobacco use and exposure, United States, 2003-2004, by

Race

Data Source

CDC, NCHS, National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS)—Outpatient Departments.

Denominator

Number of visits to office-based physicians and hospital outpatient departments.

Numerator

Number of visits to office-based physicians and hospital outpatient departments with counseling or education about tobacco use and exposure.

Comments

The NAMCS/NHAMCS question is "Therapeutic and preventive services ordered or provided at this visit" with response "Counseling/education: tobacco use/exposure."

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Ambulatory Care

Measure Title

Outpatient visits where the physician spent more than 30 minutes with the patient.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

240. Outpatient visits where the physician spent more than 30 minutes with the patient, United States, 2003-2004, by

Race

Data Source

CDC, NCHS, National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS)—Outpatient Departments.

Denominator

Number of visits to office-based physicians and hospital outpatient departments.

Numerator

Number of visits to office-based physicians and hospital outpatient departments where the physician spent more than 30 minutes with the patient.

Comments

The NAMCS/NHAMCS question is "Time spent with physician (in minutes)" with response recoded to 30 or more minutes.

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Referred Care

Measure Title

Outpatient visits where the patient was referred by another physician or health plan.

Measure Source

Centers for Disease Control and —Prevention (CDC), National Center for Health Statistics (NCHS).

Table

241. Outpatient visits where the patient was referred by another physician or health plan, United States, 2003-2004, by

Race

Data Source

CDC, NCHS, National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS)—Outpatient Departments.

Denominator

Number of visits to office-based physicians and hospital outpatient departments.

Numerator

Number of visits to office-based physicians and hospital outpatient departments where the patient was referred by another physician or health plan.

Comments

The NAMCS/NHAMCS question is "Was patient referred by another physician or by a health plan for this visit?"

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Referred Care

Measure Title

Outpatient visits where the patient was referred to another physician.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

242. Outpatient visits where the patient was referred to another physician, United States, 2003-2004, by

Race

Data Source

CDC, NCHS, National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS)—Outpatient Departments.

Denominator

Number of visits to office-based physicians and hospital outpatient departments.

Numerator

Number of visits to office-based physicians and hospital outpatient departments where the patient was referred to another physician.

Comments

The NAMCS/NHAMCS question is "Visit disposition" with response "referred to other physician."

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Emergency Care

Measure Title

Emergency department visits related to injury per 10,000 population.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Table

243. Emergency department visits related to injury or poisoning per 10,000 population, United States, 2003 and 2004, by

Race

Data Source

CDC, NCHS, National Hospital Ambulatory Medical Care Survey (NHAMCS)—Emergency Departments.

Denominator

U.S. civilian population.

Numerator

Number of visits to hospital emergency departments related to injury or poisoning.

Comments

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Emergency Care

Measure Title

Emergency department visits for asthma per 10,000 population.

Measure Source

Healthy People 2010, measure 24-3.

Table

244. Emergency department visits for asthma as the first-listed diagnosis per 10,000 population, United States, 2003-2004, by

Race

Data Source

Centers for Disease Control and Prevention, National Center for Health Statistics, National Hospital Ambulatory Medical Care Survey (NHAMCS)—Emergency Departments.

Denominator

U.S. civilian population.

Numerator

Number of visits to hospital emergency departments with first-listed diagnosis of asthma (ICD-9-CM code 493).

Comments

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Emergency Care

Measure Title

Emergency department visits where the patient was seen by an intern/resident only.

Measure Source

Healthy People 2010, measure 24-3.

Table

245. Emergency department visits where the patient was seen by an intern or a resident only, United States, 2003-2004, by

Race

Data Source

Centers for Disease Control and Prevention, National Center for Health Statistics, National Hospital Ambulatory Medical Care Survey (NHAMCS)—Emergency Departments.

Denominator

Number of visits to hospital emergency departments.

Numerator

Number of visits to hospital emergency departments where the patient was seen by an intern/resident only.

Comments

The NHAMCS ED question is "Providers seen this visit" with response "Resident/intern."