National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013
Measures
Adults who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted
Adults with Medicare or Medicaid who had an appointment for routine health care who sometimes or never got appointments for routine care as soon as wanted
Children who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted
Children who had an appointment for routine health care in the last 6 months who sometimes or never got appointments for routine care as soon as wanted
Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted
Adults with Medicare or Medicaid who needed care right away for an illness, injury, or condition who sometimes or never got care as soon as wanted
Children who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted
Children with Medicaid who needed care right away for an illness, injury, or condition who sometimes or never got care as soon as wanted
Emergency department visits where the patient was transferred or admitted to the hospital and length of visit was six hours or more
Measure Title
Adults who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)
Table Description
Geographic Representation
National
Years Available
2002-2010
Population Subgroups
Activity limitation, age, education, gender, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, U.S. born
Data Source
National AHRQ, CFACT, MEPS
Denominator
Adults age 18 and over who made an appointment for regular or routine health care in the past 12 months and had a valid response to the MEPS question, "In the last 12 months, how often did you get an appointment for regular or routine health care as soon as you wanted?"
Numerator
Subset of the denominator who answered "Sometimes" or "Never."
Comments
National Table Description report data from the MEPS Self-Administered Questionnaire (SAQ).
Measure Title
Adults with Medicare or Medicaid who had an appointment for routine health care who sometimes or never got appointments for routine care as soon as wanted
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Quality Improvement and Patient Safety (CQuIPS), National CAHPS® (Consumer Assessment of Healthcare Providers and Systems) Benchmarking Database
Table Description
Geographic Representation
State
Years Available
2010-2011
Population Subgroups
Insurance (Medicaid, Medicare managed care, Medicare fee-for-service, commercial plans)
Data Source
State
AHRQ, CQuIPS, CAHPS
Denominator
For Medicaid, respondents who answered "Yes" to the question, "In the last 6 months did you make any appointments with a doctor or other health care provider for regular or routine health care?"
For Medicare managed care and Medicare fee for service, respondents who answered "Yes" to the question, "In the last 12 months did you make any appointments with a doctor or other health care provider for regular or routine health care?"
Numerator
For Medicaid, subset of the denominator population who answered "Sometimes" or "Never" to the question, "In the last 6 months, not counting times you needed health care right away, how often did you get an appointment for health care as soon as you wanted?"
For Medicare managed care and Medicare fee for service, subset of the denominator population who answered "Sometimes" or "Never" to the question, "In the last 12 months, not counting times you needed health care right away, how often did you get an appointment for health care as soon as you wanted?"
Comments
CAHPS surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services.
Measure Title
Children who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost
Table Description
Geographic Representation
National
Years Available
2002-2010
Population Subgroups
Age, children with special health care needs, gender, geographic location (residence), health insurance, income, perceived health status, preferred language, race/ethnicity, U.S. born
Data Source
National AHRQ, CFACT, MEPS
Denominator
Children who had an appointment for regular or routine health care in the past 12 months and with a valid response to the question "In the last 12 months, how often did [the person] get an appointment for regular or routine health care as soon as you wanted?"
Numerator
Subset of the denominator who, according to their parents or guardians, answered the above question "Sometimes" or "Never."
Comments
Data are from the MEPS Child Health section. The MEPS entry in the Data Sources appendix has more information.
Nonrespondents and "Don’t Know" responses were excluded.
Measure Title
Children who had an appointment for routine health care in the last 6 months who sometimes or never got appointments for routine care as soon as wanted
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Quality Improvement and Patient Safety (CQuIPS), National CAHPS® (Consumer Assessment of Healthcare Providers and Systems) Benchmarking Database
Table Description
Geographic Representation
State
Years Available
2010-2011
Population Subgroups
Insurance (Medicaid)
Data Source
State: AHRQ, CQuIPS, CAHPS
Denominator
Children with Medicaid benefits who had appointments with a doctor or other health care provider for regular or routine health care in the last 6 months
Numerator
Subset of the denominator population with their parent or guardian’s answer of "Sometimes" or "Never" to the question, "In the last 6 months, not counting times you needed health care right away, how often did you get an appointment for health care as soon as you wanted?"
Comments
CAHPS surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services.
Measure Title
Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)
Table Description
Geographic Representation
National
Years Available
2002-2010
Population Subgroups
Activity limitation, age, education, gender, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, U.S. born
Data Sources
National AHRQ, CFACT, MEPS
Denominator
Adults age 18 and over who in the past 12 months had an illness or injury who needed care right away and had a valid response to the question, "In the last 12 months, when you needed care right away for an illness or injury, how often did you get care as soon as you wanted?"
Numerator
Subset of the denominator who responded "Sometimes" or "Never" to the above question
Comments
Nonrespondents and "Don’t Know" responses were excluded.
Measure Title
Adults with Medicare or Medicaid who needed care right away for an illness, injury, or condition who sometimes or never got care as soon as wanted
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Quality Improvement and Patient Safety (CQuIPS), National CAHPS® (Consumer Assessment of Healthcare Providers and Systems) Benchmarking Database
Table Description
Geographic Representation
State
Years Available
2010-2011
Population Subgroups
Insurance (Medicaid, Medicare managed care, Medicare fee-for-service, commercial plans)
Data Source
State: AHRQ, CQuIPS, CAHPS
Denominator
For Medicaid, adults who reported having an illness, injury, or condition that needed care right away in a clinic, emergency room, or doctor’s office in the last 6 months.
For Medicare managed care and Medicare fee for service, adults who reported having an illness, injury, or condition that needed care right away in a clinic, emergency room, or doctor’s office in the last 12 months.
Numerator
For Medicaid, subset of the denominator who answered "Sometimes" or "Never" to the question, "In the last 6 months, when you needed care right away for an illness, injury, or condition, how often did you get care as soon as you wanted?"
For Medicare managed care and Medicare fee for service, subset of the denominator who answered "Sometimes" or "Never" to the question, "In the last 12 months, when you needed care right away for an illness, injury, or condition, how often did you get care as soon as you wanted?"
Comments
CAHPS surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services.
Measure Title
Children who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)
Table Description
Geographic Representation
National
Years Available
2002-2010
Population Subgroups
Age, children with special health care needs, gender, geographic location (residence), health insurance, income, perceived health status, preferred language, race/ethnicity, U.S. born
Data Sources
AHRQ, CFACT, MEPS
Denominator
Children under age 18 who had an illness or injury that needed care right away in the past 12 months with a valid response to the question, "In the last 12 months, when [the person] needed care right away for an illness or injury, how often did [person] get care as soon as you wanted?"
Numerator
Subset of the denominator whose parents or guardians’ answered the above question "Sometimes" or "Never."
Comments
Nonrespondents and respondents indicating "Don’t Know" were excluded.
Measure Title
Children with Medicaid who needed care right away for an illness, injury, or condition who sometimes or never got care as soon as wanted
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Quality Improvement and Patient Safety (CQuIPS), National CAHPS® (Consumer Assessment of Healthcare Providers and Systems) Benchmarking Database
Table Description
Geographic Representation
State
Years Available
2010-2011
Population Subgroups
Insurance (Medicaid)
Data Source
State
AHRQ, CQuIPS, CAHPS
Denominator
Children under age 18 with Medicaid benefits who had an illness, injury, or condition that needed care right away in a clinic, emergency room, or doctor’s office in the last 6 months
Numerator
Subset of the denominator with their parent or guardian’s answer of "Sometimes" or "Never" to the question, "In the last 6 months, when you needed care right away for an illness, injury, or condition, how often did you get care as soon as you wanted?"
Comments
CAHPS surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services.
Measure Title
Emergency department visits where the patient was transferred or admitted to the hospital and length of visit was six hours or more
Measure Source
Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Hospital Ambulatory Medical Care Survey (NHAMCS)
Table Description
Geographic Representation
National
Years Available
2010-2011
Population Subgroups
Age, gender, geographic location (hospital), health insurance, race/ethnicity
Data Sources
National Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Hospital Ambulatory Medical Care Survey (NHAMCS)
Denominator
Number of visits to emergency departments where the patient disposition status was listed as transferred or admitted
Numerator
Number of visits for which the length of visit was six hours or more among the population represented by the denominator
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