National Healthcare Quality Report, 2013
Chapter 6: Text Descriptions
Figure 6.1. Composite: Adults who had a doctor's office or clinic visit in the last 12 months who reported poor communication with health providers, by insurance, ages 18-64 and age 65 and over, and activity limitation, 2002-2010
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|---|---|---|
| Any Private Insurance | 10.4% | 9.4% | 8.6% | 9.0% | 8.9% | 8.4% | 8.7% | 8.3% | 7.3% |
| Public Insurance Only | 15.6% | 15.6% | 16.4% | 15.3% | 17.4% | 15.1% | 16.2% | 13.7% | 13.9% |
| Uninsured | 18.8% | 16.7% | 18.8% | 16.4% | 16.2% | 17.3% | 15.3% | 17.6% | 16.8% |
| Total | 10.8% | 9.8% | 9.6% | 9.7% | 9.8% | 9.3% | 9.5% | 9.0% | 8.1% |
| Medicare Only | 8.7% | 6.8% | 7.3% | 7.8% | 7.6% | 7.0% | 5.7% | 6.2% | 4.5% |
| Medicare and Private Insurance | 6.6% | 5.8% | 6.0% | 5.3% | 6.3% | 5.2% | 6.1% | 4.7% | 4.4% |
| Medicare and Other Public Insurance | 8.6% | 8.6% | 8.6% | 12.0% | 12.5% | 8.7% | 10.7% | 9.6% | 7.6% |
| Basic Limitions | 12.8% | 12.0% | 12.3% | 12.7% | 12.6% | 10.3% | 12.7% | 10.8% | 11.6% |
| Complex Limitations | 15.0% | 13.5% | 14.9% | 15.4% | 15.0% | 13.9% | 16.6% | 13.6% | 13.4% |
| Neither limitation | 10.3% | 9.3% | 8.8% | 8.8% | 9.1% | 8.9% | 8.7% | 8.5% | 7.3% |
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: Civilian noninstitutionalized population age 18 and over who had a doctor's office or clinic visit in the last 12 months.
Note: For this measure, lower rates are better. Patients who report that their health providers sometimes or never listened carefully, explained things clearly, showed respect for what they had to say, or spent enough time with them are considered to have poor communication. 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 6.2. Composite: Children who had a doctor's office or clinic visit in the last 12 months whose parents reported poor communication with health providers, by insurance and primary language, 2002-2010
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|---|---|---|
| Any Private Insurance | 5.3% | 4.7% | 4.1% | 4.0% | 3.5% | 4.0% | 3.3% | 3.6% | 2.4% |
| Public Insurance Only | 10.6% | 9.4% | 8.8% | 8.6% | 7.7% | 6.5% | 6.5% | 7.5% | 6.6% |
| Uninsured | 7.3% | 6.4% | 9.5% | 7.2% | 5.7% | 7.2% | 6.3% | 4.4% | 5.6% |
| Total | 6.7% | 6.1% | 5.7% | 5.5% | 4.8% | 4.9% | 4.4% | 4.9% | 4.0% |
| English | 6.3% | 5.6% | 5.4% | 5.0% | 4.6% | 4.5% | 4.1% | 4.3% | 3.8% |
| Other | 11.7% | 9.5% | 8.0% | 8.7% | 6.7% | 7.1% | 5.9% | 8.0% | 5.2% |
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: Civilian noninstitutionalized population under age 18 who had a doctor's office or clinic visit in the last 12 months.
Note: For this measure, lower rates are better. Parents who report that their child's health providers sometimes or never listened carefully, explained things clearly, showed respect for what they had to say, or spent enough time with them are considered to have poor communication.
Figure 6.3. Adult hospital patients who reported poor communication with nurses and doctors, by age, 2009-2012
| Poor Communication With Nurses | 2009 | 2010 | 2011 | 2012 |
|---|---|---|---|---|
| 18-44 | 6.2% | 5.9% | 5.6% | 5.2% |
| 45-64 | 6.4% | 6.1% | 5.8% | 5.5% |
| 65+ | 5.4% | 5.1% | 4.9% | 4.4% |
| Total | 5.9% | 5.6% | 5.3% | 4.9% |
| Poor Communication With Doctors | 2009 | 2010 | 2011 | 2012 |
| 18-44 | 5.0% | 5.0% | 4.9% | 4.8% |
| 45-64 | 5.7% | 5.7% | 5.7% | 5.6% |
| 65+ | 5.1% | 5.1% | 5.0% | 4.7% |
| Total | 5.3% | 5.3% | 5.2% | 5.0% |
Source: Agency for Healthcare Research and Quality, Hospital CAHPS (Consumer Assessment of Healthcare Providers and Systems) Survey, 2009-2012.
Denominator: Adult hospital patients.
Note: For this measure, lower rates are better. Poor communication is defined as responded sometimes or never to the set of survey questions: "During this hospital stay, how often did doctors/nurses treat you with courtesy and respect?" "During this hospital stay, how often did doctors/nurses listen carefully to you?" and "During this hospital stay, how often did doctors/nurses explain things in a way you could understand?"
Figure 6.4. State variation: Adult hospital patients who reported poor communication with doctors, 2012
| First (best) Quartile | Second Quartile | Third Quartile | Fourth (worst) Quartile |
|---|---|---|---|
| Hawaii | Colorado | Alabama | Arizona |
| Iowa | Connecticut | Alaska | District of Columbia |
| Kansas | Idaho | Arkansas | Florida |
| Louisiana | Illinois | California | Kentucky |
| Maine | Indiana | Delaware | Maryland |
| Minnesota | Massachusetts | Georgia | Michigan |
| Montana | Mississippi | Missouri | Nevada |
| Nebraska | New Hampshire | North Carolina | New Jersey |
| Oregon | Ohio | North Dakota | New Mexico |
| South Dakota | Oklahoma | Pennsylvania | New York |
| Utah | Rhode Island | South Carolina | Tennessee |
| Vermont | Washington | Texas | West Virginia |
| Wisconsin | Wyoming | Virginia | - |
| Missing: Puerto Rico |
Source: Agency for Healthcare Research and Quality, Hospital CAHPS (Consumer Assessment of Healthcare Providers and Systems) Survey, 2009-2012.
Denominator: Adult hospital patients
Figure 6.5. Provider-patient communication among adults receiving home health care, by language spoken at home, 2011-2012
| Always inform you about when they will arrive | Always explain things in a way you can understand | Always listen carefully to you | Always treat you as gently as possible | Always treat you with courtesy and respect | |
|---|---|---|---|---|---|
| Total | 78.8% | 82.3% | 83.9% | 90.0% | 93.2% |
| English | 79.4% | 83.0% | 84.3% | 90.7% | 93.8% |
| Spanish | 75.4% | 80.3% | 86.5% | 87.5% | 92.7% |
| Other | 74.8% | 77.1% | 80.3% | 83.4% | 86.8% |
Source: Centers for Medicare & Medicaid Services, Home Health Care CAHPS (Consumer Assessment of Healthcare Providers and Systems) Survey, 2011-2012.
Denominator: Adults who had at least two visits from a Medicare-certified home health agency during a 2-month look-back period. Patients receiving hospice care and who had "maternity" as the primary reason for receiving home health care are excluded.
Figure 6.6. People with a usual source of care whose health providers sometimes or never asked for the patient's help to make treatment decisions, by activity limitations, 2002-2010
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|---|---|---|
| Basic Limitations | 26.0% | 23.9% | 22.9% | 22.9% | 19.6% | 20.1% | 18.5% | 20.6% | 17.4% |
| Complex Limitations | 27.5% | 26.0% | 23.8% | 23.9% | 20.4% | 19.9% | 19.9% | 21.3% | 18.8% |
| Neither Limitation | 20.8% | 17.9% | 16.7% | 16.6% | 16.3% | 15.5% | 15.1% | 14.8% | 12.5% |
| Total | 21.9% | 18.9% | 17.7% | 17.2% | 17.3% | 15.9% | 15.6% | 15.4% | 13.2% |
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: Civilian noninstitutionalized population with a usual source of care.
Note: For this measure, lower rates are better. Activity limitation status applies only to adults age 18 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.
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