Effectiveness of Care: Racial and Ethnic Minorities

Measure Title

Adults who did not receive a cholesterol check in the last 5 years.

Measure Source

Healthy People 2010.

Table

16_1_1.1 Adults who did not receive a cholesterol check in the last 5 years, United States, 2005

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

Denominator

U.S. residents age 18 and over.

Numerator

Subset of the denominator who reported they did not receive a cholesterol check.

Comments

Native Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.

Measure Title

Adults age 65 and over who did not receive a flu shot in the last 12 months.

Measure Source

Healthy People 2010.

Table

16_1_2.1 Adults age 65 and over who did not receive a flu shot in the last 12 months, United States, 2006

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

Denominator

U.S. residents age 18 and over.

Numerator

Subset of the denominator age 65 and over who reported they did not receive a flu shot.

Comments

Native Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.

Measure Title

Adults age 65 and over who never received a pneumococcal vaccine.

Measure Source

Healthy People 2010.

Table

16_1_3.1 Adults age 65 and over who did not ever receive a pneumococcal vaccine, United States, 2006

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

Denominator

U.S. residents age 18 and over.

Numerator

Subset of the denominator age 65 and over who reported they did not receive a pneumococcal vaccine.

Comments

Native Hawaiian and Other Pacific Islander (NHOPI0 includes people of mixed race who identified NHOPI to be the race that best represents their identity.

Measure Title

Adults under age 65 without health insurance.

Measure Source

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

Table

16_1_4.1 Adults without any health insurance in the last 12 months, United States, 2006

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

Denominator

U.S. residents ages 18-64.

Numerator

Subset of the denominator who reported they did not have any health insurance.

Comments

Native Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.

Measure Title

Adults who reported they did not have a personal doctor.

Measure Source

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

Table

16_1_5.1 Adults who reported they did not have a personal doctor, United States, 2006

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

Denominator

U.S. residents age 18 and over.

Numerator

Subset of the denominator who reported they did not have a personal doctor.

Comments

Native Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.

Measure Title

Adults who needed to see a doctor but could not because of cost in the last 12 months.

Measure Source

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

Table

16_1_6.1 People who needed to see a doctor but could not because of cost in the last 12 months, United States, 2006

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

Denominator

U.S. residents.

Numerator

Subset of the denominator who reported they could not see a doctor because of cost.

Comments

Native Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.

Measure Title

Adults age 50 and over who did not receive a blood stool test in the last 2 years or did not ever have a sigmoidoscopy/colonoscopy.

Measure Source

Healthy People 2010.

Table

16_1_7.1 Adults age 50 and over who did not receive a blood stool test in the last 2 years or had not ever had a sigmoidoscopy/colonoscopy, United States, 2006

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

Denominator

U.S. residents age 50 and over.

Numerator

Subset of the denominator age 50 and over who reported they did not receive a blood stool test or had not ever had a sigmoidoscopy/colonoscopy.

Comments

Native Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.

Measure Title

Hospital admissions for uncontrolled diabetes per 100,000 population age 18 years and over in Indian Health Service tribal direct and contract hospitals and community hospitals.

Measure Source

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

Table

16_2_1.1 Hospital admissions for uncontrolled diabetes per 100,000 population age 18 and over in Indian Health Service tribal direct and contract hospitals and community hospitals, 2005

Data Source

Indian Health Service (IHS), Office of Information Technology/National Patient Information Reporting System (OIT/NPIRS), National Data Warehouse, Workload and Population Data Mart.

Denominator

IHS service population, age 18 and over, 2006.

Numerator

Adult nonmaternal, nonneonatal admissions, age 18 and over, with a principal diagnosis of uncontrolled diabetes, without mention of short-term (ketoacidosis, hyperosmolarity, coma) or long-term complications (renal, eye, neurologic, circulatory, other unspecified) and excluding transfers from other institutions.

Comments

Because the California and Portland Areas have no IHS or tribal inpatient facilities, any hospitalizations attributed to either one of these regions were not included; the denominator was correspondingly reduced. Rates were computed using estimates of the American Indian/Alaska Native population as of July 1, 2006, based on the 2000 census.

Data for the total were age adjusted using the 2000 standard population provided by NCHS: http://www.cdc.gov/nchs/data/statnt/statnt20.pdf (Plugin Software Help).

The numerator includes hospitalizations in IHS hospitals and contract hospitals with admission dates from January 1, 2006, to December 31, 2006, inclusive.

The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes used to identify discharges for uncontrolled diabetes are the same as AHRQ Prevention Quality Indicator 2, but the format of NPIRS did not allow for exclusion of transfers.

Measure Title

Perforated appendixes per 1,000 admissions with appendicitis, age 18 years and over with appendicitis in IHS tribal direct and contract hospitals and community hospitals.

Measure Source

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

Tables

16_2_2.1 Perforated appendixes per 1,000 admissions with appendicitis, age 18 and over, in Indian Health Service tribal direct and contract hospitals and community hospitals, 2005

16_2_2.2 Admissions with perforated appendix per 1,000 admissions, age 18 and over, with appendicitis (excluding obstetric admissions and transfers from other institutions), United States, 2005, by:

• Race/ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file.

Denominator

Number of admissions with a primary or secondary diagnosis of appendicitis, excluding maternal and neonatal admissions and transfers from other institutions, age 18 and over, IHS service population, 2006.

Numerator

Subset of the denominator with principal or secondary diagnosis of perforation or abscess of the appendix, IHS service population, 2006.

Comments

Because the California and Portland Areas have no IHS or tribal inpatient facilities, any hospitalizations attributed to either one of these regions were not included; the denominator was correspondingly reduced. Rates were computed using estimates of the American Indian/Alaska Native population as of July 1, 2006, based on the 2000 census.

Data for the total were age adjusted using the 2000 standard population provided by NCHS: http://www.cdc.gov/nchs/data/statnt/statnt20.pdf (Plugin Software Help).

The numerator and denominator include hospitalizations in IHS hospitals and contract hospitals with admission dates from January 1, 2006, to December 31, 2006, inclusive.

The SID 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, AR, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, OK, RI, SC, TN, TX, VT, and WI.

Measure Title

Hospitalizations for urinary tract infection per 100,000 population 18 years and over in IHS tribal direct and contract hospitals and community hospitals.

Measure Source

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

Tables

16_2_3.1 Hospitalizations for urinary tract infection per 100,000 population 18 years and over in Indian Health Service tribal direct and contract hospitals and community hospitals, 2005

16_2_3.2 Admissions for urinary tract infections (excluding kidney or urinary tract disorders, patients in an immunocompromised state, transfers from other institutions, and obstetric admissions) per 100,000 population, age 18 and over, United States, 2005, by:

• Race/ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file.

Denominator

IHS service population, age 18 and over, 2006.

Numerator

Adult nonmaternal, nonneonatal admissions, excluding cases with a diagnosis of a kidney/urinary tract disorder or immunocompromised state and transfers from other institutions, with a principal diagnosis of urinary tract infection, 2006.

Comments

Because the California and Portland Areas have no IHS or tribal inpatient facilities, any hospitalizations attributed to either one of these regions were not included; the denominator was correspondingly reduced. Rates were computed using estimates of the American Indian/Alaska Native population as of July 1, 2006, based on the 2000 census.

Data for the total were age adjusted using a standard population provided by NCHS: http://www.cdc.gov/nchs/data/statnt/statnt20.pdf (Plugin Software Help).

The numerator includes hospitalizations in IHS hospitals and contract hospitals with admission dates from January 1, 2006, to December 31, 2006, inclusive.

The SID 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, AR, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, OK, RI, SC, TN, TX, VT, and WI.

Measure Title

Completion of therapy for tuberculosis within 12 months of being diagnosed among people born outside the United States.

Measure Source

American Thoracic Society.

Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination.

Tables

8_2_9.2 Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment, United States, 2004, by:

• Race.
• Ethnicity.
• Race (foreign born only).
• Ethnicity (foreign born only).

Data Source

CDC, National Tuberculosis Surveillance System (NTBSS).

Denominator

U.S. resident population with verified tuberculosis (TB), eligible to complete therapy within 1 year.

Numerator

Tuberculosis cases completing therapy within 1 year.

Comments

See American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America. Treatment of tuberculosis. Am J Respir Crit Care Med 2003;167:603-62. This article has more information on current tuberculosis treatment guidelines.

For a discussion of completion of TB therapy, see Appendix A of Reported tuberculosis in the United States, 2003, available at http://www.cdc.gov/tb/statistics/reports/surv2003/default.htm.

This measure and its tables are also presented in other relevant sections of the National Healthcare Disparities Report.

Measure Title

Composite measure: Adults who had a doctor's office or clinic visit in the last 12 months whose health providers listened carefully, explained things clearly, respected what they had to say, and spent enough time with them.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Consumer Assessment of Healthcare Providers and Systems (CAHPS^®).

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

Tables

12_1_1.3 Adults who had a doctor's office or clinic visit in the last 12 months whose health providers always listened carefully, explained things clearly, respected what they had to say, and spent enough time with them, United States, 2005, by:

• Race.
• Ethnicity.
• Family income.
• Education.

12_1_1.4 Adults who had a doctor's office or clinic visit in the last 12 months whose health providers usually listened carefully, explained things clearly, respected what they had to say, and spent enough time with them, United States, 2005, by:

• Race.
• Ethnicity.
• Family income.
• Education.

12_1_1.5 Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never listened carefully, explained things clearly, respected what they had to say, and spent enough time with them, United States, 2005, by:

• Race.
• Ethnicity.
• Family income.
• Education.

Data Source

AHRQ, CFACT, MEPS.

Denominator

U.S. civilian noninstitutionalized adults age 18 and over who had at least one visit to a doctor's office or clinic in the previous 12 months (not including visits to an emergency room).

Numerator

U.S. civilian noninstitutionalized adults age 18 and over who had at least one visit to a doctor's office or clinic in the previous 12 months (not including visits to an emergency room) who subsequently reported their provider's level of communication on some or all of the four components of the composite measure as always, usually, sometimes, or never; depending on the table.

Comments

This measure and its tables are also presented in other relevant sections of the National Healthcare Disparities Report.

Percentage estimates are weighted; percentage weights are adjusted for nonresponse based on how many questions had a valid response.

Tables report data from the MEPS Self-Administered Questionnaire (SAQ). See the MEPS entry in the Data Sources appendix for more information on the SAQ.

Measure Title

Adults under age 65 who were uninsured all year.

Measure Source

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

Tables

14_1_5.1 People under age 65 who were uninsured all year, United States, 2005, by:

• Race.
• Ethnicity.
• Family income.
• Education.

Data Source

AHRQ, CFACT, MEPS.

Denominator

U.S. civilian noninstitutionalized population under age 65.

Numerator

U.S. civilian noninstitutionalized population under age 65 who reported no private or public health insurance coverage at any time during the year.

Comments

This measure and its tables are also presented in other relevant sections of the National Healthcare Disparities Report.

Measure Title

Adults with limited English proficiency, by whether they had a usual source of care with or without language assistance.

Measure Source

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

Table

16_3_4.1 Adults with limited English proficiency, by whether they had a usual source of care (USC) with or without language assistance, United States, 2005

Data Source

AHRQ, CFACT, MEPS.

Denominator

U.S. civilian noninstitutionalized population with limited English proficiency.

Numerator

Subset of the denominator with and without a usual source of care who offers language assistance.

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