Chapter 7 (Text Descriptions)

National Healthcare Quality Report, 2011

Figure 7.1. Adults age 65 and over who received potentially inappropriate prescription medications in the calendar year, by age and insurance status, 2002-2008

Age	2002	2003	2004	2005	2006	2007	2008
65-69	16.2%	18.4%	16.4%	18.4%	15.5%	15.2%	12.8%
70-74	20.6%	19.1%	16.3%	18.2%	15.1%	15.9%	13.6%
75-79	19.8%	17.2%	18.8%	19.6%	15.2%	15.7%	16.6%
80+	20.8%	18.9%	15.8%	15.0%	17.1%	15.1%	11.8%

Insurance Status	2002	2003	2004	2005	2006	2007	2008
Medicare Only	17.9%	16.9%	16.3%	16.8%	16.2%	14.6%	10.9%
Medicare and Private	18.9%	19.2%	16.8%	17.3%	15.7%	16.0%	15.1%
Medicare and Public	26.9%	19.7%	18.1%	21.7%	17.2%	16.2%	15.4%
Total	19.3%	18.5%	16.7%	17.7%	15.8%	15.4%	13.4%

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2008.

Denominator: Civilian noninstitutionalized population age 65 and over.

Note: For this measure, lower rates are better. Prescription medications received include all prescribed medications initially purchased or otherwise obtained, as well as any refills. Medicare + public are individuals with Medicare and some other public insurance (e.g., Medicaid).

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Figure 7.2. National trends in potentially avoidable hospitalization rates for adults, by type of hospitalization, 2000-2008

Type of Hospitalization	2000	2001	2002	2003	2004	2005	2006	2007	2008
Overall (rate per 100,000 pop.)	1656.9	1635.3	1684.0	1613.6	1559.1	1562.1	1502.3	1458.3	1433.5
Acute (rate per 100,000 pop.)	714.2	702.4	745.3	713.3	686.4	716.9	655.9	649.6	638.1
Chronic (rate per 100,000 pop.)	942.8	933.0	938.9	900.4	872.8	845.3	846.5	808.8	795.4

Source: Source: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, and AHRQ Quality Indicators, modified version of 4.1, 2000-2008.

Denominator: Civilian noninstitutionalized adults age 18 and over.

Note: For this measure, lower rates are better. Annual rates are adjusted for age and gender.

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Figure 7.3. Total national costs associated with potentially avoidable hospitalizations, 2000-2008

Costs	2000	2001	2002	2003	2004	2005	2006	2007	2008
Overall (costs in billions of 2008 dollars)	24.9	25.2	27.4	28	27.4	27.3	26.9	26.6	26.4
Acute (costs in billions of 2008 dollars)	10.5	10.5	11.6	11.8	11.5	11.9	10.9	11.2	11.1
Chronic (costs in billions of 2008 dollars)	14.3	14.8	15.7	16.2	15.9	15.4	15.9	15.3	15.3

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Figure 7.4. Medicare home health patients with potentially avoidable hospitalizations within 30 days of start of care, by age, 2000-2010

Age	2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010
65-74	4.7%	4.4%	4.3%	4.2%	4.3%	3.8%	3.5%	3.5%	3.4%	3.4%	3.2%
75-84	4.7%	4.6%	4.6%	4.5%	4.8%	4.2%	3.9%	3.9%	3.8%	3.7%	3.6%
85+	4.7%	5.0%	5.0%	4.9%	4.9%	4.7%	4.4%	4.3%	4.3%	4.1%	4.1%

Source: Centers for Medicare & Medicaid Services, Outcome and Assessment Information Set linked with Medicare Part A claims (100%), 2000-2010.

Denominator: Adult nonmaternity patients starting an episode of skilled home health care.

Note: For this measure, lower rates are better. Rates standardized to the 2006 patient population according to Medicare enrollment category.

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Figure 7.5. Perforated appendixes per 1,000 admissions for appendicitis, by age and gender, 2004-2008

Age	2004	2005	2006	2007	2008
18-44 (per 1,000 admissions)	215.6	206.9	206.9	203.4	192.7
45-64 (per 1,000 admissions)	401	398.5	398.5	390.8	377
65-69 (per 1,000 admissions)	487.4	489.1	489.1	483.8	492.4
70-74 (per 1,000 admissions)	549.7	490.3	490.3	495.5	524.3
75-79 (per 1,000 admissions)	557.6	576.8	576.8	535.1	507.8
80-84 (per 1,000 admissions)	608.3	600.6	600.6	546.1	549.4
85+ (per 1,000 admissions)	602.5	604.6	604.6	593.8	529.8

Gender	2004	2005	2007	2008
Male (per 1,000 admissions)	313.1	305.5	303.3	289
Female (per 1,000 admissions)	267.9	260.6	249.2	246

Source: Agency for Healthcare Research and Quality, HCUP SID disparities analysis file, 2004, 2005, 2007, and 2008.

Note: For this measure, lower rates are better. Data for 2006 are not included, because a new version of the PQI software was used to calculate rates and 2006 was not included in the calculation.

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Figure 7.6. Males age 75 and over who reported having a prostate-specific antigen test or a digital rectal exam within the last 12 months, by education and health status, 2004-2010

Education	2004	2006	2008	2010
Any College	75.9%	77.1%	77.9%	77.4%
High School Grad	69.1%	69.7%	71.8%	72.5%
<High School	62.4%	64.0%	63.6%	64.0%

Health Status	2004	2006	2008	2010
Excellent/Very Good/Good	72.6%	74.8%	74.4%	75.7%
Fair/Poor	68.0%	68.1%	72.2%	70.6%

Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2004, 2006, 2008, and 2010.

Denominator: Adult males age 75 and over with no history of prostate cancer.

Note: Data for 2004, 2006, and part of 2008 precede the U.S. Preventive Services Task Force recommendation against screening men age 75 and over. It should be noted that PSA tests and DREs are provided to this population for purposes unrelated to prostate cancer screening. Data to determine the purpose of these services were unavailable and all reported PSA tests and DREs are reflected in the data shown.
2008 achievable benchmark: 62%.

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Figure 7.7. Average estimated relative hospital cost efficiency index for a selected sample of urban general community hospitals, 2004-2008

Year	Average estimated relative hospital cost efficiency index
2004	100.0
2005	99.6
2006	99.6
2007	99.8
2008	99.8

Source: Agency for Healthcare Research and Quality. Analysis based on 2008 values for 1,590 urban general community hospitals.

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Page last reviewed October 2014

Internet Citation: Chapter 7 (Text Descriptions): National Healthcare Quality Report, 2011. October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/research/findings/nhqrdr/nhqr11/chap7txt.html