In 1999, Congress mandated that the Agency for Healthcare Research and Quality (AHRQ) report annually to the Nation about health care quality and disparities. An interagency workgroup developed the Preliminary Measure Set for the National Healthcare Quality Report (NHQR). Select for Background on the NHQR preliminary measures.
For 2004, the NHQR and the National Healthcare Disparities Report (NHDR) have been designed and planned as companion reports. To ensure uniformity, these two reports will use identical measures of quality of health care to the extent possible with available data.
The measures of quality of care used in the NHQR will be used in the NHDR too; the NHDR will also use additional measures. Because of data unavailability, examining disparities in some of these quality measures were not possible in the first NHDR.
Select for Background on the preliminary measures and the Update on the National Healthcare Quality Report.
Cancer / Diabetes / End Stage Renal Disease / Heart
Disease / HIV/AIDS / Maternal and
Child Health / Mental Health /
Nursing Home and Home Health Care / Respiratory Diseases
Cancer / Diabetes / End Stage Renal Disease / Heart Disease / HIV/AIDS / Maternal and Child Health / Mental Health / Nursing Home and Home Health Care / Respiratory Diseases
| Measure | Measure Specificationsa | National Databasea | State Databasea | |
|---|---|---|---|---|
| Cancer: Screening for breast cancer | Process: % of women (age 40 and over) who report they had a mammogram within the past 2 years | HP2010(3-13) | NHIS | BRFSS |
| Outcome: Rate of breast cancers diagnosed at advanced stage | SEER program | SEER | n.a. | |
| Cancer: Screening for cervical cancer | Process: % of women (age18 and over) who report that they had a Pap smear within the past 3 years | HP2010(3-11b) | NHIS | BRFSS |
| Outcome: Rate of cervical cancers diagnosed as invasive (includes local, regional, and distant disease except in situ disease) | SEER program | SEER | n.a. | |
| Cancer: Screening for colorectal cancer | Process: % of men and women (age 50 and over) who report they ever had a flexible sigmoidoscopy/colonoscopy | HP2010(3-12b) | NHIS | BRFSS |
| Process: % of men and women (age 50 and over) who report they had a fecal occult blood test (FOBT) within the past 2 years | HP2010(3-12a) | NHIS | BRFSS | |
| Outcome: Rate of colorectal cancers diagnosed as regional or distant staged cancers | SEER program | SEER | n.a. | |
| Cancer: Cancer treatment | Outcome: Cancer deaths per 100,000 persons per year for all cancers | HP2010(3-1) | Vital statistics | Vital statistics |
| Outcome: Cancer deaths per 100,000 persons per year for most common cancers, prostate cancer | HP2010(3-7) | Vital statistics | Vital statistics | |
| Outcome: Cancer deaths per 100,000 persons per year for most common cancers, breast cancer | HP2010(3-3) | Vital statistics | Vital statistics | |
| Outcome: Cancer deaths per 100,000 persons per year for most common cancers, lung cancer | HP2010(3-2) | Vital statistics | Vital statistics | |
| Outcome: Cancer deaths per 100,000 persons per year for most common cancers, colorectal cancer | HP2010(3-5) | Vital statistics | Vital statistics | |
| Esophageal resection mortality rate | AHRQ-QI | HCUP NIS | n.a. | |
| Pancreatic resection mortality rate | AHRQ-QI | HCUP NIS | n.a. | |
| Diabetes: Management of diabetes | Process: % of adults with diabetes who had a hemoglobin A1c measurement at least once in past year | Specs for MEPS | MEPS | BRFSS |
| Process: % of patients with diabetes who had a lipid profile in past two years | Specs for MEPS | MEPS | n.a. | |
| Process: % of adults with diabetes who had a retinal eye examination in past year | Specs for MEPS | MEPS | BRFSS | |
| Process: % of adults with diabetes who had a foot examination in past year | Specs for MEPS | MEPS | BRFSS | |
| Process: % of adults with diabetes who had an influenza immunization in past year | Specs for MEPS | MEPS | BRFSS | |
| Outcome: Percent of adults with diagnosed diabetes with HbA1c level > 9% (poor control); < 7.0 (optimal) | National Diabetes Quality Improvement Alliance | NHANES | n.a. | |
| Outcome: % of adults with diagnosed diabetes with most recent
LDL-C level < 130 mg/dL (minimally acceptable); < 100 (optimal) [b] |
National Diabetes Quality Improvement Alliance | NHANES | n.a. | |
| Outcome: % of adults with diagnosed diabetes with most recent blood pressure < 140/90 mm/Hg | National Diabetes Quality Improvement Alliance | NHANES | n.a. | |
| Outcome: Hospital admissions for uncontrolled diabetes per 100,000 population | AHRQ-QI | HCUP NIS | n.a. | |
| Outcome: Hospital admissions for short term complications of diabetes per 100,000 population | AHRQ-QI | HCUP NIS | n.a. | |
| Outcome: Hospital admissions for long term complications of diabetes per 100,000 population | AHRQ-QI | HCUP NIS | n.a. | |
| Outcome: Hospital admissions for lower extremity amputations in patients with diabetes per 1000 population | HP 2010(5-10) | NHDS | n.a. | |
| End Stage Renal Disease: Management of End Stage Renal Disease | Process: % of dialysis patients registered on waiting list for transplantation | HP2010 4-5 | USRDS | USRDS |
Process: % of patients with treated chronic kidney failure who receive a transplant within 3 years of renal failure |
HP2010 4-6 | USRDS | USRDS | |
| Outcome: % of hemodialysis patients with urea reduction ration (URR) of 65 or greater | CMS | ESRD Clinical Performance Measures Project | U. Michigan | |
| Outcome:% of patients with hematocrit 33 or greater or hemoglobin 11 or greater | CMS | ESRD Clinical Performance Measures Project | U. Michigan | |
| Outcome: Patient survival rate | CMS | ESRD Clinical Performance Measures Project | U. Michigan | |
| Use of arteriovenous fistulas—New hemodialysis patients (aged 20 years and over) | CMS | ESRD Clinical Performance Measures Project | n.a. | |
| Heart Disease: Screening for high blood pressure | Process: % of people age 18 and over who have had blood pressure measured within preceding 2 years and can state whether their blood pressure is normal or high | HP2010 | NHIS | BRFSS |
| Heart Disease: Screening for high cholesterol | Process: % of adults 18 and over receiving cholesterol measurement within 5 years | HP2010(12-15) | NHIS | BRFSS |
| Heart Disease: Counseling on risk factors | Process: % of smokers receiving advice to quit smoking | HP2010(1-3c) | MEPS | BRFSS |
| Heart Disease: Treatment of AMI | Process: % of AMI patients administered aspirin within 24 hours of admission | QIO scope of work | QIO | QIO |
| Process: % of AMI patients with aspirin prescribed at discharge | QIO scope of work | QIO | QIO | |
| Process: % of AMI patients administered beta blocker within 24 hours of admission | QIO scope of work | QIO | QIO | |
| Process: % of AMI patients with beta blocker prescribed at discharge | QIO scope of work | QIO | QIO | |
| Process: % of AMI patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge | QIO scope of work | QIO | QIO | |
| Process: % of AMI patients given smoking cessation counseling while hospitalized | QIO scope of work | QIO | QIO | |
| Process: Median Time to Thrombolysis. Time from arrival to initiation of a thrombolytic agent in patients with ST segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time | QIO scope of work | QIO | QIO | |
| Process: Median time to PTCA. Median time from arrival to percutaneous transluminal angioplasty (PTCA) in patients with ST segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time. | QIO scope of work | QIO | QIO | |
| Heart Disease: Treatment of acute heart failure | Process: % of heart failure patients having evaluation of left ventricular ejection fraction | QIO scope of work | QIO | QIO |
| Process: % of heart failure patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge | QIO scope of work | QIO | QIO | |
| Heart Disease: Management of hypertension | Outcome: % of people with hypertension who have blood pressure under control | HP2010(12-10) | NHANES | n.a. |
| Heart Disease: Management of CHF | Outcome: Hospital admissions for congestive heart failure (CHF) per 1,000 population | HP2010(12-6) | NHDS | n.a. |
| Heart Disease: Heart disease treatment | Pediatric heart surgery mortality rate (number of deaths per 100 heart surgeries in patients under age 18 years) | AHRQ-QI | HCUP NIS | n.a. |
| AAA repair mortality rate (number of deaths per 100 AAA repairs) | AHRQ-QI | HCUP NIS | n.a. | |
| CABG mortality rate (number of deaths per 100 CABG procedures) | AHRQ-QI | HCUP NIS | n.a. | |
| PTCA mortality rate (number of deaths per 100 PTCAs) | AHRQ-QI | HCUP NIS | n.a. | |
| Acute myocardial infarction (AMI) mortality rate (number of deaths per 100 discharges for AMI) | AHRQ-QI | HCUP NIS | n.a. | |
| Congestive heart failure (CHF) mortality rate (number of deaths per 100 discharges for CHF) | AHRQ-QI | HCUP NIS | n.a. | |
| HIV/AIDS: AIDS prevention | Outcome: New AIDS cases per 100,000 population (age 13 and over) | HP2010(13-1) | CDC-AIDS | n.a. |
| HIV/AIDS: Management of HIV/AIDS | Outcome: HIV-infection deaths per 100,000 population | HP2010(13-14) | Vital statistics | Vital statistics |
| Maternal and Child Health: Maternity care | Process: % of pregnant women receiving prenatal care in first trimester | HP2010(16-6a) | Vital statistics | Vital statistics |
| Outcome: % of liveborn infants with low and very low birthweight (less than 2,500 grams, less than 1,500 grams) | HP2010(16-10) | Vital statistics | Vital statistics | |
| Outcome: Infant mortality per 1,000 live births | HP2010(16-1c) | Vital statistics | Vital statistics | |
| Outcome: Maternal deaths per 100,000 live births | HP2010(16-4) | Vital statistics | Vital statistics | |
| Maternal and Child Health: Immunization, childhood | Process: % of children 19-35 months who received all recommended vaccines | HP2010(14-24a) | NIS | NIS |
| Maternal and Child Health: Immunization, adolescent | Process: % of adolescents (age 13-15) reported to have received 3 or more doses of hepatitis B vaccine | HP2010(14-27a) | NHIS | n.a. |
| Process: % of adolescents (age 13-15) reported to have received 2 or more doses of MMR vaccine | HP2010(14-27b) | NHIS | n.a. | |
| Process: % of adolescents (age 13-15) reported to have received 1 or more doses of tetanus-diphtheria booster | HP2010(14-27c) | NHIS | n.a. | |
| Process: % of adolescents (age 13-15) reported to have received 3 or more doses of varicella vaccine | HP2010(14-27d) | NHIS | n.a. | |
| Maternal and Child Health: Childhood dental care | Process: % of children age 2-17 who report dental visit in last year | HP 2010(21-10) | MEPS | n.a. |
| Maternal and Child Health: Treatment of pediatric gastroenteritis | Outcome: Hospital admissions for pediatric gastroenteritis per 100,000 population less than 18 years of age | AHRQ-QI | HCUP NIS | n.a. |
| Maternal and Child Health: Childhood preventive care | Whether the doctor or other health professional measured height and weight of child | Specs for MEPS | MEPS | n.a. |
| Whether the doctor or other health professional gave advice about amount and kind of physical activity | Specs for MEPS | MEPS | n.a. | |
| Whether the individual ever received advice from doctor or the health professional about eating healthy | Specs for MEPS | MEPS | n.a. | |
| Whether the doctor or other health professional checked for vision. | Specs for MEPS | MEPS | n.a. | |
| Whether the doctor or other health professional gave advice to parent or guardian about how smoking in the house can be harmful (i.e., passive smoking question) | Specs for MEPS | MEPS | n.a. | |
| Whether the doctor or other health professional gave advice about using child car safety seat OR booster seat OR lap and shoulder belts (age appropriate questions asked) | Specs for MEPS | MEPS | n.a. | |
| Whether the doctor or other health professional recommended using a helmet while riding a bike or motorcycle | Specs for MEPS | MEPS | n.a. | |
| Mental Health: Treatment of depression | Process: % of adults diagnosed with a new episode of depression who had optimal practitioner contacts for medication management during the acute treatment phase | NCQA | HEDIS | n.a. |
| Process: % of adults diagnosed with a new episode of depression and initiated on an antidepressant drug who received a continuous trial of medication treatment during the acute treatment phase | NCQA | HEDIS | n.a. | |
| Process: % of adults diagnosed with a new episode of depression and initiated on an antidepressant drug who remained on an antidepressant medication through the continuation phase of treatment | NCQA | HEDIS | n.a. | |
| Outcome: Deaths due to suicide per 100,000 population | HP2010(18-1) | Vital statistics | Vital statistics | |
| Respiratory Diseases: Immunization, influenza | Process: % of high risk persons (e.g. COPD) age 18-64 who received an influenza vaccination in the past 12 months | HP2010(14-29c) | NHIS | BRFSS |
| Process: % of persons age 65 and over who received an influenza vaccination in the past 12 months | HP2010(14-29a) | NHIS | BRFSS | |
| Process: % of institutionalized adults (persons in long-term care or nursing homes) who received influenza vaccination in past 12 months | HP2010(14-29e) | NNHS | n.a. | |
| Outcome: Hospital admissions for immunization-preventable influenza per 100,000 population | HP2010(1-9c, approximate) AHRQ-QI | HCUP NIS | n.a. | |
| Respiratory Diseases: Immunization, pneumonia | Process: % of high risk persons (e.g. COPD) age 18-64 who ever received a pneumococcol vaccination | HP2010(14-29d) | NHIS | BRFSS |
| Process: % of persons age 65 and over who ever received a pneumococcol vaccination | HP2010(14-29b) | NHIS | BRFSS | |
| Process: % of institutionalized adults (persons in long-term care or nursing homes) who ever received pneumococcol vaccination | HP2010(14-29f) | NNHS | n.a. | |
| Respiratory Diseases: Treatment of pneumonia | Process: % of patients with pneumonia who have blood cultures collected before antibiotics are administered | QIO scope of work | n.a. | QIO |
| Process: percent of patients with pneumonia who receive the initial antibiotic dose within 4 hours of hospital arrival | QIO scope of work | n.a. | QIO | |
| Process: % of patients with pneumonia who receive the initial antibiotic consistent with current recommendations | QIO scope of work | n.a. | QIO | |
| Process: % of patients with pneumonia who receive influenza screening or vaccination | QIO scope of work | n.a. | QIO | |
| Process: % of patients with pneumonia who receive pneumococcal screening or vaccination | QIO scope of work | n.a. | QIO | |
| Pneumonia mortality rate (number of deaths per 100 discharges for pneumonia) | AHRQ-QI | AHRQ NIS | n.a. | |
| Respiratory Diseases: Treatment of URI | Process: % of visits where antibiotic was prescribed for the diagnosis of a common cold, children & Adults | HP2010(14-19) | NAMCS-NHAMCS | n.a. |
| Respiratory Diseases: Management of asthma | Process: % of people with persistent asthma who are prescribed medications acceptable as primary therapy for long-term control of asthma (inhaled corticosteroids) | NCQA | HEDIS | n.a. |
| Outcome: Hospital admissions for pediatric asthma per 10,000 population under age 18 | HP2010(24-2, 1-9a) | NHDS | n.a. | |
| Outcome: Hospital admissions for asthma per 10,000 population | HP2010(24-2) | NHDS | n.a. | |
| Outcome: Hospital admissions for asthma per 100,000 population age 65 and over | AHRQ-QI | HCUP NIS | n.a. | |
| Respiratory Diseases: Treatment of TB | Process: Percent of TB patients that complete a curative course of TB treatment within 12 months of initiation of treatment | HP2010(14-12) | CDC, TB | n.a. |
| Nursing Home and Home Health Care: Nursing facility care | Percent of residents whose need for help with daily activities has increased | CMS | n.a. | MDS |
| Percent of residents who have moderate to severe pain | CMS | n.a. | MDS | |
| Percent of residents who were physically restrained | CMS | n.a. | MDS | |
| Percent of residents who spent most of their time in bed or in a chair | CMS | n.a. | MDS | |
| Percent of residents whose ability to move about in and around their room got worse | CMS | n.a. | MDS | |
| Percent of residents with a urinary tract infection | CMS | n.a. | MDS | |
| Percent of residents who have become more depressed or anxious | CMS | n.a. | MDS | |
| Percent of high risk residents who have pressure sores | CMS | n.a. | MDS | |
| Percent of low risk residents who have pressure sores | CMS | n.a. | MDS | |
| Percent of low risk residents who lose control of their bowels or bladder | CMS | n.a. | MDS | |
| Percent of residents who have/had a catheter inserted and left in their bladder | CMS | n.a. | MDS | |
| Percent of short stay residents who had moderate to severe pain | CMS | n.a. | MDS | |
| Percent of short stay residents with delirium | CMS | n.a. | MDS | |
| Percent of short stay residents with pressure sores | CMS | n.a. | MDS | |
| Nursing Home and Home Health Care: Home health care | Outcome: improvement in upper body dressing | CMS | n.a. | OASIS |
| Outcome: improvement in management of oral medications | CMS | n.a. | OASIS | |
| Outcome: improvement in bathing | CMS | n.a. | OASIS | |
| Outcome: stabilization in bathing | CMS | n.a. | OASIS | |
| Outcome: improvement in transferring | CMS | n.a. | OASIS | |
| Outcome: improvement in ambulation/locomotion | CMS | n.a. | OASIS | |
| Outcome: improvement in toileting | CMS | n.a. | OASIS | |
| Outcome: improvement in pain interfering with activity | CMS | n.a. | OASIS | |
| Outcome: improvement in dyspnea | CMS | n.a. | OASIS | |
| Outcome: improvement in urinary incontinence | CMS | n.a. | OASIS | |
| Outcome: improvement in confusion frequency | CMS | n.a. | OASIS | |
| Outcome: acute care hospitalization | CMS | n.a. | OASIS |