National Healthcare Quality Report, 2013
Chapter 3: Text Descriptions
Figure 3.1. Infants born in 2010 whose mothers had obtained early and adequate prenatal care, by State quartiles
| First Quartile (worst) | Second Quartile | Third Quartile | Fourth Quartile (best) | Missing | Missing |
|---|---|---|---|---|---|
| Colorado | Florida | Delaware | California | Alabama | Minnesota |
| Maryland | Georgia | Idaho | Iowa | Alaska | Mississippi |
| Nevada | Indiana | Illinois | Kansas | Arizona | New Jersey |
| New Mexico | New York | Kentucky | Michigan | Arkansas | North Carolina |
| Oklahoma | Ohio | Montana | Missouri | Connecticut | Rhode Island |
| Pennsylvania | South Carolina | Nebraska | New Hampshire | Hawaii | Virginia |
| Texas | South Dakota | North Dakota | Oregon | Louisiana | West Virginia |
| Washington | Wyoming | Tennessee | Utah | Maine | Wisconsin |
| District of Columbia | NA | NA | Vermont | Massachusetts | Puerto Rico |
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Vital Statistics, National Vital Statistics System, 2010.
Note: Georgia, Maryland, Nevada, and DC were missing information on prenatal care for >15% of records. Go to ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/DVS/natality/UserGuide2010.pdf (PDF File, 1.4 MB).
Figure 3.2. Children ages 19-35 months who received the 4:3:1:3:3:1:4 vaccine series, by income, 2009-2011
| Income | 2009 | 2010 | 2011 |
|---|---|---|---|
| Total | 63.6% | 70.2% | 68.5% |
| Poor | 61.7% | 67.7% | 63.9% |
| Low Income | 63.3% | 69.3% | 67.2% |
| Middle Income | 62.7% | 70.2% | 72.4% |
| High Income | 68.1% | 75.1% | 75.2% |
Source: Centers for Disease Control and Prevention, National Center for Health Statistics and National Center for Immunization and Respiratory Diseases, National Immunization Survey, 2009-2011.
Denominator: U.S. civilian noninstitutionalized population ages 19-35 months.
Note: Full series of Haemophilus influenza type b (Hib) vaccine is greater than or equal to 3 or greater than or equal to 4 doses depending on brand type.
2010 Achievable Benchmark: 72%
Figure 3.3. Children ages 2-17 with a dental visit in the calendar year, by insurance status and age, 2002-2010
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|---|---|---|
| Any Private | 56.9% | 57.9% | 59.6% | 58.7% | 59.6% | 59.7% | 56.5% | 57.5% | 56.6% |
| Public Only | 35.8% | 38.8% | 39.3% | 38.4% | 41.4% | 41.8% | 40.5% | 42.7% | 43.6% |
| Uninsured | 25.5% | 31.7% | 27.4% | 24.5% | 27.9% | 33.5% | 25.9% | 26.9% | 31.8% |
| Total | 49.1% | 50.9% | 51.6% | 50.7% | 52.2% | 52.2% | 49.3% | 50.9% | 50.6% |
| 2-5 | 30.5% | 33.3% | 36.1% | 34.6% | 36.9% | 34.5% | 35.7% | 37.3% | 36.8% |
| 6-17 | 55% | 56.6% | 56.5% | 55.9% | 57.3% | 57.9% | 53.8% | 55.6% | 55.4% |
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: U.S. civilian noninstitutionalized population ages 2-17.
Figure 3.4. Children ages 3-9 and 13-15 with untreated dental caries, by age, 2009-2010 combined
| Year | 3-5 | 6-12 | 13-15 |
|---|---|---|---|
| 2009-2010 | 14.4% | 17.0% | 11.4% |
Source: Dye BA, Li X, Thornton-Evans G. Oral health disparities as determined by selected Healthy People 2020 oral health objectives fort he United States, 2009-2010. NCHS data brief, no 104. Hyattsville, MD: National Center for Health Statistics; 2012.
Denominator: U.S. civilian noninstitutionalized population ages 3-9 and 13-15.
Note: For this measure, lower rates are better. Data for ages 10-12 are unavailable.
Figure 3.5. Children ages 0-17 with a well-child visit in the last 12 months, by insurance status and age, 2011-2012 combined
| Percent | |
|---|---|
| Private Insurance | 87.8 |
| Public Insurance | 84.1 |
| Uninsured | 53.7 |
| 0-5 | 89.7 |
| 6-11 | 82.0 |
| 12-17 | 81.7 |
Source: Data Resource Center for Child and Adolescent Health; National Survey of Children's Health, 2011-2012.
Denominator: Civilian noninstitutionalized population ages 0-17.
Figure 3.6. Adolescents ages 13-15 who ever received at least 1 dose of the meningococcal vaccine, by sex and residence location, 2008-2011
| 2008 | 2009 | 2010 | 2011 | |
|---|---|---|---|---|
| Total | 43.9% | 54.8% | 64.8% | 71.5% |
| Female | 45.4% | 55.2% | 65.4% | 70.3% |
| Male | 42.4% | 54.5% | 64.2% | 72.6% |
| Metropolitan | 47.1% | 58.2% | 67.9% | 73.8% |
| Nonmetropolitan | 27.1% | 36.6% | 48.1% | 58.0% |
Source: Centers for Disease Control and Prevention, National Center for Health Statistics and National Center for Immunization and Respiratory Diseases, National Immunization Survey, 2008-2011.
2009 Achievable Benchmark: 75%
Figure 3.7. Teens 15-19 years old who received counseling or information from a health care provider during the last 12 months about birth control, by sex, age group, and insurance status, 2007-2010 combined
| Males | Females | |
|---|---|---|
| Private Insurance | 13.8% | 15.8% |
| Public Insurance | 19.2% | 21.9% |
| Uninsured | 9.8% | 15.1% |
| 15-17 | 12.9% | 12.6% |
| 18-19 | 17.8% | 23.6% |
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Family Growth, 2007-2010.
Denominator: People ages 15-19 years old.
Figure 3.8. Adult current smokers with a checkup in the last 12 months who received advice to quit smoking, by age and activity limitation, 2002-2010
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|---|---|---|
| Total | 63.1% | 65.3% | 63.1% | 63.4% | 62.7% | 65.1% | 64.5% | 67.6% | 65.7% |
| 18-44 | 57.1% | 59.7% | 58.5% | 56.4% | 52.5% | 61.1% | 57.4% | 60.1% | 59.9% |
| 45-64 | 69.2% | 71.9% | 68.5% | 70.5% | 73.4% | 70.9% | 72.3% | 78.7% | 71.8% |
| 65+ | 71.2% | 71.5% | 67.9% | 73.0% | 75.5% | 67.6% | 73.3% | 71.7% | 73.1% |
| Basic Limitations | 63.9% | 73.3% | 69.8% | 70.8% | 74.2% | 71.3% | 73.9% | 80.6% | 71.3% |
| Complex Limitations | 65.0% | 74.1% | 74.8% | 75.9% | 78.4% | 68.2% | 77.6% | 79.1% | 71.2% |
| Neither Limitation | 62.3% | 63.4% | 61.1% | 61.1% | 59.8% | 64.0% | 62.6% | 65.2% | 64.6% |
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: Civilian noninstitutionalized adult current smokers who had a checkup in the last 12 months.
Note: Estimates are age adjusted to the 2000 U.S. standard population using three age groups: 18-44, 45-64, and 65 and over. Basic activity limitations include problems with mobility, self-care, domestic life, or activities that depend on sensory functioning. Complex activity limitations include limitations experienced in work or in community, social, and civic life.
Figure 3.9. Adults with obesity who ever received advice from a health provider to exercise more, by insurance (ages 18-64) and activity limitations, 2002-2010
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|---|---|---|
| Private | 56.9% | 58.5% | 58.6% | 58.2% | 58.5% | 59.8% | 59.7% | 60.7% | 60.5% |
| Public | 53.6% | 58.2% | 60.7% | 58.1% | 59.2% | 59.7% | 58.5% | 61.2% | 61.5% |
| Uninsured | 40.8% | 40.5% | 36.3% | 38.1% | 41.5% | 39.4% | 42.8% | 45.3% | 43.8% |
| Total | 55.6% | 57% | 57.2% | 56.7% | 57.1% | 57.9% | 57.4% | 59.1% | 58.4% |
| Basic Limitations | 65.9% | 70.3% | 71.7% | 67.6% | 70.2% | 71.2% | 65.1% | 68.2% | 68.6% |
| Complex Limitations | 67.3% | 67.4% | 68.4% | 66.7% | 68.4% | 71.4% | 67.9% | 67.8% | 65.7% |
| Neither Limitation | 53.8% | 54.7% | 54.9% | 54.5% | 54.5% | 56.3% | 55.5% | 57.9% | 57% |
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: Civilian noninstitutionalized adults age 18 and over with obesity.
Note: Estimates are age adjusted to the 2000 U.S. standard population using three age groups: 18-44, 45-64, and 65 and over. Obesity is defined as a body mass index of 30 or higher. Basic activity limitations include problems with mobility, self-care, domestic life, or activities that depend on sensory functioning. Complex activity limitations include limitations experienced in work or in community, social, and civic life.
Figure 3.10. Adults with obesity who did not spend half an hour or more in moderate or vigorous physical activity at least three times a week, by sex and age, 2002-2010
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|---|---|---|
| Total | 54.3% | 54.3% | 53.0% | 52.0% | 52.3% | 53.3% | 53.1% | 51.7% | 48.8% |
| Male | 50.2% | 49% | 47.4% | 46.8% | 48.0% | 48.5% | 47.7% | 46.9% | 43.5% |
| Female | 58.1% | 58.8% | 58.0% | 56.6% | 56.7% | 57.9% | 58.2% | 56.2% | 53.6% |
| 18-44 | 48.9% | 51.6% | 49.4% | 47.2% | 48.0% | 48.6% | 48.8% | 46.3% | 43.2% |
| 45-64 | 58.7% | 55.2% | 54.4% | 54.0% | 54.4% | 55.9% | 54.7% | 54.8% | 52.4% |
| 65+ | 63.6% | 60.9% | 61.9% | 63.4% | 62.2% | 63.1% | 63.9% | 63.1% | 60.1% |
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: Civilian noninstitutionalized population age 18 and over with obesity.
Note: For this measure, lower rates are better. Estimates are age adjusted to the 2000 U.S. standard population using three age groups: 18-44, 45-64, and 65 and over. Obesity is defined as a body mass index of 30 or higher.
Figure 3.11. Children ages 2-17 for whom a health provider gave advice within the past 2 years about exercise, by insurance and special health care needs, 2002-2010
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|---|---|---|
| Private | 31.6% | 30.2% | 32.2% | 32.9% | 35.3% | 37.4% | 35.2% | 36.4% | 42.5% |
| Public | 28.1% | 29.2% | 30.2% | 31.6% | 34.5% | 35.2% | 33.0% | 33.4% | 37.2% |
| Uninsured | 22.5% | 20.9% | 22.6% | 23.0% | 27.2% | 30.3% | 22.8% | 23.5% | 26.0% |
| CSHCN | 39.6% | 36.7% | 39.1% | 41.1% | 41.3% | 43.7% | 42.8% | 44.2% | 48.6% |
| Not CSHCN | 27.5% | 27.3% | 28.9% | 29.5% | 32.8% | 34.2% | 31.2% | 32.1% | 37.4% |
| Total | 30.0% | 29.3% | 31.0% | 31.9% | 34.6% | 36.2% | 33.5% | 34.7% | 39.7% |
Key: CSHCN = children with special health care needs. See Medical Expenditure Panel Survey documentation for the 2010 Full Year Consolidated Data File at http://meps.ahrq.gov/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-138 for details.
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: U.S. civilian noninstitutionalized population ages 2-17.
Note: Exercise advice includes the amount and kind of exercise, sports or physically active hobbies children should engage in.
Figure 3.12. Adults with obesity who ever received advice from a health provider about eating fewer high-fat or high-cholesterol foods, by insurance (ages 18-64) and activity limitations, 2002-2010
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|---|---|---|
| Total | 47.7% | 48.3% | 47.4% | 48.1% | 48.5% | 50.0% | 49.2% | 51.3% | 51.4% |
| Private | 47.1% | 48.0% | 47.4% | 47.6% | 47.1% | 49.3% | 49.0% | 50.8% | 50.9% |
| Public | 44.9% | 47.3% | 47.5% | 47.5% | 49.7% | 50.8% | 48.7% | 51.1% | 56.4% |
| Uninsured | 33.6% | 34.4% | 27.6% | 29.7% | 32.3% | 32.3% | 36.9% | 38.2% | 37.4% |
| Basic Limitations | 57.5% | 62.2% | 60.7% | 58.6% | 62.0% | 65.0% | 53.6% | 60.8% | 63.3% |
| Complex Limitations | 59.4% | 60.1% | 60.2% | 61.0% | 63.7% | 64.1% | 58.8% | 58.7% | 63.8% |
| Neither Limitation | 45.9% | 46.0% | 45.3% | 45.6% | 45.6% | 47.4% | 47.5% | 50.4% | 49.7% |
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: Civilian noninstitutionalized population age 18 and over with obesity.
Note: Estimates are age adjusted to the 2000 U.S. standard population using three age groups: 18-44, 45-64, and 65 and over. Obesity is defined as a body mass index of 30 or higher. Basic activity limitations include problems with mobility, self-care, domestic life, or activities that depend on sensory functioning. Complex activity limitations include limitations experienced in work or in community, social, and civic life.
Figure 3.13. Children ages 2-17 for whom a health provider ever gave advice about healthy eating, by insurance and special health care needs, 2002-2010
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|---|---|---|
| Private | 48.9% | 48.5% | 50.3% | 52.2% | 53.3% | 54.4% | 50.6% | 50.6% | 57.4% |
| Public | 45.5% | 48.2% | 49.1% | 48.7% | 50.1% | 52.0% | 52.2% | 51.1% | 55.7% |
| Uninsured | 34.6% | 34.2% | 33.4% | 33.9% | 37.0% | 43.6% | 31.6% | 30.5% | 39.8% |
| Total | 46.9% | 47.5% | 48.7% | 50.1% | 51.4% | 52.8% | 49.6% | 49.5% | 55.7% |
| CSHCN | 53.5% | 55.1% | 56.3% | 58.8% | 57.5% | 60.3% | 58.2% | 58.8% | 62.6% |
| Not CSHCN | 45.3% | 45.4% | 46.8% | 47.7% | 49.8% | 50.9% | 47.4% | 47.1% | 53.9% |
Key: CSHCN = children with special health care needs. See Medical Expenditure Panel Survey documentation for the 2010 Full Year Consolidated Data File at http://meps.ahrq.gov/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-138 for details.
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: U.S. civilian noninstitutionalized population ages 2-17.
Figure 3.14. Adult home health care patients whose ability to walk or move around improved, by age, 2010-2011
| 2010 | 2011 | |
|---|---|---|
| Total | 54.4% | 57.0% |
| 18-64 | 55.0% | 57.3% |
| 65-74 | 62.0% | 64.1% |
| 75-84 | 55.7% | 58.5% |
| 85+ | 45.6% | 48.7% |
Source: Centers for Medicare & Medicaid Services, Outcome and Assessment Information Set (OASIS), 2010-2011.
Denominator: Adult nonmaternity patients completing an episode of skilled home health care and not already performing at the highest level at the start of the episode, according to the OASIS question on ambulation.
2010 Achievable Benchmark: 62.5%
Figure 3.15. Long-stay nursing home residents whose need for help with daily activities increased, by age and sex, 2011
| Percent | |
|---|---|
| Total | 18.3 |
| 0-64 | 12.9 |
| 65-74 | 16.8 |
| 75-84 | 19.0 |
| 85+ | 20.0 |
| Males | 18.0 |
| Females | 18.4 |
Source: Centers for Medicare & Medicaid Services, Minimum Data Set, 2011. Data are from the third quarter of the calendar year.
Denominator: All long-stay residents in Medicare- or Medicaid-certified nursing home facilities.
Note: For this measure, lower rates are better.
2011 Achievable Benchmark: 15%
Figure 3.16. Functional Independence Measure scores at admission and discharge by type of function, 2011
| Type of Function | Admission | Discharge |
|---|---|---|
| Locomotion | 1.6 | 4.0 |
| Transfer | 2.6 | 4.8 |
| Self-Care | 3.4 | 5.3 |
| Sphincter Control | 3.8 | 5.3 |
| Social Cognition | 4.7 | 5.6 |
| Communication | 5.0 | 5.9 |
Source: Centers for Medicare & Medicaid Services, Inpatient Rehabilitation Facility Patient Assessment Instrument, 2011.
Denominator: All Medicare patients in an inpatient rehabilitation facility for initial rehabilitation and discharged to the community (home, board and care, transitional living, or assisted living).
Note: Functional score ranges from 1 (worst ability) to 7 (full function). FIM motor scores cover locomotion, transfer, self-care, and sphincter control.
Figure 3.17. Adult home health care patients who had less shortness of breath between the start and end of a home health care episode, by age, 2002-2011
| Year | Total | 18-64 | 65-74 | 75-84 | 85+ |
|---|---|---|---|---|---|
| 2002 | 53.3% | 51.8% | 54.6% | 53.8% | 51.8% |
| 2003 | 55.1% | 53.3% | 56.6% | 55.7% | 53.5% |
| 2004 | 57.6% | 55.8% | 59.1% | 58.2% | 56.0% |
| 2005 | 58.9% | 56.9% | 60.6% | 59.6% | 57.4% |
| 2006 | 60.8% | 58.5% | 62.4% | 61.6% | 59.3% |
| 2007 | 61.3% | 59.0% | 62.8% | 62.1% | 59.8% |
| 2008 | 60.5% | 58.3% | 62.3% | 61.3% | 58.9% |
| 2009 | 60.1% | 58.0% | 62.1% | 60.9% | 58.5% |
| 2010 | 62.3% | 60.6% | 63.7% | 63.0% | 61.0% |
| 2011 | 63.0% | 61.1% | 64.0% | 63.9% | 62.1% |
Source: Centers for Medicare & Medicaid Services, Outcome and Assessment Information Set (OASIS), 2002-2011.
Denominator: Adult nonmaternity patients completing an episode of skilled home health care.
Note: Starting January 1, 2010, the patient assessment instrument for home health agencies was changed to OASIS-C. Because dyspnea improvement is measured similarly in both the previous and current versions of the assessment instrument, we are presenting 2002 through 2011 trend data.
2008 Achievable Benchmark: 68%
Figure 3.18. Long-stay nursing home residents who have moderate to severe pain, by age and sex, 2011
| Percent | |
|---|---|
| Total | 14.7 |
| 0-64 | 22.4 |
| 65-74 | 18.9 |
| 75-84 | 14.8 |
| 85+ | 10.8 |
| Males | 12.9 |
| Females | 15.6 |
Source: Centers for Medicare & Medicaid Services, Minimum Data Set, 2011. Data are from the third quarter of the calendar year.
Denominator: All long-stay residents in Medicare- or Medicaid-certified nursing home facilities.
Note: For this measure, lower rates are better.
2011 Achievable Benchmark: 8.1%
Figure 3.19. Hospice patients age 18 and over who did NOT receive the right amount of help for feelings of anxiety or sadness, by age, 2008-2012
| Age | 2008 | 2009 | 2010 | 2011 | 2012 |
|---|---|---|---|---|---|
| Total | 9.7% | 9.4% | 9.5% | 9.8% | 9.4% |
| 18-44 | 14.7% | 12.9% | 11.8% | 13.8% | 12.6% |
| 45-64 | 11.2% | 10.8% | 11.3% | 12.0% | 11.1% |
| 65+ | 9.4% | 9.1% | 9.2% | 9.4% | 9.14% |
Source: National Hospice and Palliative Care Organization, Family Evaluation of Hospice Care, 2008-2012.
Denominator: Adult hospice patients.
Note: For this measure, lower rates are better.
2009 Achievable Benchmark: 6.4%
Figure 3.20. Hospice patients age 18 and over whose family caregivers wanted more information about what to expect while the patient was dying, by age, 2008-2012
| Age | 2008 | 2009 | 2010 | 2011 | 2012 |
|---|---|---|---|---|---|
| Total | 15.3% | 15.0% | 14.9% | 15.3% | 14.98% |
| 18-44 | 18.1% | 19.2% | 19.1% | 19.3% | 19.31% |
| 45-64 | 18.3% | 18.5% | 17.8% | 18.7% | 18% |
| 65+ | 14.7% | 14.4% | 14.4% | 14.9% | 14.59% |
Source: National Hospice and Palliative Care Organization, Family Evaluation of Hospice Care, 2008-2012.
Denominator: Adult hospice patients.
Note: For this measure, lower rates are better.
2008 Achievable Benchmark: 11%
Figure 3.21. Hospice patients age 18 and over who did NOT receive care consistent with their stated end-of-life wishes, by age, 2008-2012
| Age | 2008 | 2009 | 2010 | 2011 | 2012 |
|---|---|---|---|---|---|
| Total | 5.8% | 5.4% | 5.6% | 5.4% | 5.2% |
| 18-44 | 10.7% | 6.6% | 5.7% | 10.0% | 7.0% |
| 45-64 | 6.9% | 6.7% | 6.6% | 6.8% | 6.8% |
| 65+ | 5.6% | 5.3% | 5.5% | 5.1% | 5.0% |
Source: National Hospice and Palliative Care Organization, Family Evaluation of Hospice Care, 2008-2012.
Denominator: Adult hospice patients.
Note: For this measure, lower rates are better.
2008 Achievable Benchmark: 3.5%
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