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Chartbook on Care Affordability

Measures of Inefficiency

Inefficient care includes delayed care that is more costly and care with costs that exceed benefits.

  • Ruptured appendix per 1,000 adult admissions with appendicitis.
  • Men age 40+ who had a screening prostate-specific antigen test in the past year.

Ruptured Appendix

Ruptured appendix per 1,000 adult admissions with appendicitis, by race/ethnicity and insurance, 2001-2012

Charts show ruptured appendixes per 1,000 adult admissions with appendicitis, by race/ethnicity and insurance. For details, go to tables below.

Left Chart:

Year Total White Black Hispanic API
2001 332.71 323.80 378.47 334.66 331.11
2002 326.72 322.40 364.12 319.74 289.35
2003 318.09 313.96 353.44 306.91 287.19
2004 309.49 306.78 327.83 304.49 284.01
2005 304.82 301.34 335.53 296.69 284.29
2006 303.58 298.07 342.65 297.96 284.18
2007 295.21 289.75 321.68 287.87 281.39
2008 296.66 294.42 316.13 283.82 275.14
2009 292.43 292.77 309.63 269.40 271.92
2010 300.79 302.65 320.45 273.18 299.27
2011 307.38 311.44 324.89 273.43 298.67
2012 313.56 319.11 316.06 283.90 317.63

Right Chart:

Insurance 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Private Insurance 309.71 305.61 304.99 298.01 288.77 284.96 281.92 274.30 280.34 288.83 290.55 309.9
Medicare 394.19 361.72 395.89 384.29 346.96 364.49 330.97 299.27 322.76 352.28 303.84 351.4
Medicaid 348.72 347.80 354.22 344.18 316.50 314.56 314.90 308.86 277.43 310.60 284.66 302.45
Other Insurance 346.81 348.85 355.51 347.31 305.82 351.72 318.83 307.79 338.05 311.06 330.06 332.0
Uninsured 352.01 349.86 346.85 340.92 348.96 348.41 309.66 321.65 308.52 350.46 317.13 330.38

Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, State Inpatient Databases, disparities analysis files and Nationwide Inpatient Sample, 2001-2012.
Denominator: Adults age 18 and over.
Note: For this measure, lower rates are better. Annual rates are adjusted for age and gender.

  • Importance: Timely assessment of abdominal pain and diagnosis of appendicitis reduces rates of ruptured appendix.
  • Overall Rate: In 2012, there were 314 ruptured appendixes for every 1,000 adult admissions with appendicitis.
  • Trends:
    • From 2001 to 2012, there were no statistically significant changes in the overall rate.
    • The rate improved among Blacks and Hispanics and among people with Medicare, Medicaid, and other insurance.
  • Groups With Disparities: In 2012, the rate of ruptured appendix was:
    • Lower among Hispanics compared with Whites.
    • Higher among people whose primary payer was Medicare compared with people whose primary payer was private insurance.
  • Achievable Benchmark:
    • In 2008, the top 4 State (Connecticut, Hawaii, Massachusetts, New Jersey) achievable benchmark for ruptured appendix per 1,000 admissions with appendicitis was 232.
    • No group reached the benchmark by 2012.

Men Age 40+ Who Had a Screening Prostate-Specific Antigen Test

Men age 40+ who had a screening prostate-specific antigen test in the past year, by age, race, and education, 2012

Chart shows percent of men age 40+ who had a screening prostate-specific antigen test in the past year, by age, race, and education. For details, go to table below.

Race and Education 40-54 55-74 75+
Total 18.5 47.3 49.4
White 18.7 49.0 50.0
Black 23.7 45.5 50.2
Asian 8.9 33.6 43.7
AI/AN 16.9 35.6 37.9
<High School 10.6 31.7 39.7
High School Grad 18.4 44.1 50.9
Any College 20.9 52.6 53.0

Key: AI/AN = American Indian or Alaska Native.
Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance Survey, 2012.
Denominator: Men age 40 and over.
Note: For this measure, lower rates are better.

  • Importance: Finding more harm than benefit, in 2008, the U.S. Preventive Services Task Force recommended against screening men age 75 and over with prostate-specific antigen (PSA) tests.  In 2012, this recommendation was extended to all men.
  • Overall Rate: In 2012, half of men age 40 and over reported a PSA test in the past year (data not shown).
  • Groups With Disparities:
    • Among men ages 55-74, Blacks, Asians, and American Indians and Alaska Natives were less likely than Whites to receive PSA testing.
    • In 2012, men with less than a high school education were less likely than men with any college to receive PSA testing across all age groups. High school graduates ages 40-54 and 55-74 were also less likely to receive PSA testing than men with any college.

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Page last reviewed June 2015
Page originally created September 2015

The information on this page is archived and provided for reference purposes only.

 
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