In 1999, Congress mandated that the Agency for Healthcare Research and Quality (AHRQ) report annually to the Nation about health care disparities. An interagency workgroup developed the Preliminary Measure Set for the National Healthcare Disparities Report (NHDR). Select for Background on the NHDR preliminary measures.
The NHDR and the National Healthcare Quality Report (NHQR) have been designed and planned as companion reports. To ensure uniformity, these two reports use identical measures of quality of health care to the extent possible with available data. To access the measures of quality of care used in both reports, go to the NHQR Proposed 2004 Final Measure Set.
In addition to examining disparities in quality of health care, the NHDR also examines disparities in access to health care. These Proposed 2004 Final Measures are listed below.
Access to the Health Care System
Health Insurance Coverage
/ Usual Source of Care / Unmet
Need
Structural Barriers Within the System
Getting Care
Ability of Provider to Address Patient Needs
Patient-Physician Communication
/ Patient-Physician Relationship /
Cultural Competency / Health
Information
Health Care Utilization
Routine and Acute
Care / Chronic Care / Avoidable
Admissions / Mental Health & Substance Abuse / HIV Care
| Measures | National Databasea | Consensus Processb | |
|---|---|---|---|
| Health Insurance Coverage | % of persons with health insurance | NHIS | HP2010 |
| % of persons with any private insurance coverage | NHIS | ||
| % of persons with only public insurance coverage | NHIS | ||
| % of persons uninsured all year | MEPS | ||
| % of persons with any period of public insurance during a year | MEPS | ||
| % of persons with any period of uninsurance during a year | MEPS | ||
| % of persons offered health insurance coverage through their employer or a family member's employer | MEPS | ||
| Usual Source of Care | % of persons who have a specific source of ongoing care | NHIS | HP2010 |
| % of persons in fair or poor health who have a specific source of ongoing care | NHIS | ||
| % of persons with hospital outpatient department as usual source of care | NHIS | ||
| % of persons with hospital emergency department as usual source of care | NHIS | ||
| Main reason no usual source of healthcare | MEPS | ||
| % of persons with a usual primary care provider | MEPS | HP2010 | |
| Unmet Need |
% of families that experience difficulties or delays in obtaining health care or do not receive needed care for one or more family members | MEPS | HP2010 |
| Main problem that caused family member's difficulty, delay, or not receiving needed health care | MEPS | ||
| % of families in which a family member did not receive doctor's care or prescription medications because the family needed the money | MEPS | ||
| Satisfied that your family can get health care if they need it | MEPS |
| Measures | National Databasea | Consensus Processb | |
|---|---|---|---|
| Getting Care | Does provider have office hours at night or on weekends? | MEPS | |
| How difficult is it to get appointment with provider on short notice? | MEPS | ||
| How difficult is it to contact provider over the telephone about a health problem? | MEPS | ||
| How much of a problem was it to get a referral to a specialist that you need to see? | MEPS | ||
| How satisfied with professional staff | MEPS |
| Measures | National Databasea | Consensus Processb | |
|---|---|---|---|
| Patient-Physician
Communication |
Does provider generally listen | MEPS | |
| Does provider usually ask about prescription medications and treatments other doctors may give | MEPS | ||
| Does provider listen carefully | MEPS | ||
| Does provider explain things | MEPS | ||
| Does provider show respect for what you had to say | MEPS | ||
| Patient-Physician Relationship | Satisfied with quality of care received from provider | MEPS | |
| Are they confident in provider's ability to help when they have a medical problem | MEPS | ||
| Provider spend enough time with you | MEPS |
| Measures | National Databasea | Consensus Processb | |
|---|---|---|---|
| Routine and Acute Care | % of persons with office or outpatient visit | MEPS | |
| % of persons with prescription medication | MEPS | ||
| % of persons with dental visit | MEPS | ||
| % of persons with emergency room visit | MEPS | ||
| % of persons with inpatient discharge | MEPS | ||
| Outpatient visits per population | National Ambulatory Medical Care Survey / National Hospital Ambulatory Medical Care Survey | ||
| Emergency department visits per population | National Hospital Ambulatory Medical Care Survey | ||
| Total hospitalizations per population | National Hospital Discharge Survey | ||
| Chronic Care | % of Medicare beneficiaries 65 and over with Medicare-covered home health care | Medicare Current Beneficiary Survey | |
| % of Medicare beneficiaries under 65 with Medicare-covered home health care | Medicare Current Beneficiary Survey | ||
| % of Medicare beneficiaries 65 and over with nursing home care in past year | Medicare Current Beneficiary Survey | ||
| % of Medicare beneficiaries under 65 with nursing home care in past year | Medicare Current Beneficiary Survey | ||
| Avoidable Admissions | Admissions for hypertension per 100,000 population 18 and older | HCUP | |
| Admissions for angina per 100,000 population 18 and older | HCUP | ||
| Admissions for chronic obstructive pulmonary disease per 100,000 population 18 and older | HCUP | ||
| Admissions for bacterial pneumonia per 100,000 population | HCUP | ||
| Admissions for perforated appendix per 1,000 admissions with appendicitis | HCUP | ||
| Mental Health / Substance Abuse | % of adults who received mental health treatment or counseling in the past year | National Survey on Drug Use and Health | |
| % of adults who received outpatient mental health treatment or counseling | National Survey on Drug Use and Health | ||
| % of adults who received prescription medications for mental health treatment | National Survey on Drug Use and Health | ||
| % of adults with serious mental illness who received inpatient mental health treatment or counseling | National Survey on Drug Use and Health | ||
| % of adults with serious mental illness who received mental health treatment or counseling | National Survey on Drug Use and Health | ||
| % of persons 12 or older who received illicit drug or alcohol abuse treatment in the past year | National Survey on Drug Use and Health | ||
| % of persons 12 or older who received illicit drug use and who received such treatment in the past year | National Survey on Drug Use and Health | ||
| HIV Care | Hospitalizations for HIV per population | National Hospital Discharge Survey |
|
| % of HIV patients with 4+ ambulatory visits in the past year | HIV Research Network |
||
| % of HIV patients with CD4 <50 with 4+ ambulatory visits in the past year | HIV Research Network |
||
| % of HIV patients with inpatient hospitalizations in the past year | HIV Research Network |
||
| % of HIV patients with CD4 <50 with inpatient hospitalization in the past year | HIV Research Network |
[a] AHRQ-PSI, AHRQ-PQI, AHRQ-IQI=AHRQ
Quality Indicators (prevention, inpatient and patient safety indicators).
BRFSS=Behavioral Risk Factor Surveillance System.
CDC TB=Centers for Disease Control & Prevention National Tuberclosis Surveillance
System.
HCUP=Healthcare Cost and Utilization Project.
HEDIS=Health Plan and Employer Data Information Set.
HP2010=Healthy People 2010.
JCAHO=Joint Commission for Accreditation of Healthcare Organization's hospital
core measures.
LHI=Leading Health Indicators.
MEPS=Medical Expenditure Panel Survey.
MDS=Minimum Data Set.
MPSMS=Medicare Patient Safety Monitoring System.
NAMCS=National Ambulatory Medical Care Survey.
NCBD=National CAHPS® Benchmarking Database.
NCQA=National Committee for Quality Assurance' s HEDIS measure set.
NHA=National Health Accounts.
NHANES=National Health and Nutrition Examination Survey.
NHIS=National Health Interview Survey.
NHHCS=National Home Health and Hospice Care Survey.
NHAMCS=National Hospital Ambulatory Medical Care Survey.
NHDS=National Hospital Discharge Survey.
NIS=National Immunization Survey.
NNHS=National Nursing Home Survey.
NQF=National Quality Forum.
OECD=Organization for Economic Cooperation & Development Health Data File.
Vital statistics=National Vital Statistics System, Mortality.
SEER=Surveillance, Epidemiology, and End Results Program.
USRDS=United States Renal Data System.
WHO=World Health Organization.
[b] Measure listed is part of approved final NHQR measure set. However, data were unavailable for the first NHQR.
Current as of May 2004
Internet Citation:
2004 Proposed Final Measure Set, National Healthcare Disparities Report. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/nhdr04/premeasures.htm
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