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 a
preliminary measure set for the National Healthcare Disparities Report (NHDR).
Select for Background
on the original NHDR measures development process.
The NHDR and the National Healthcare Quality Report
(NHQR) were 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. (Because of data unavailability, examining
disparities in some of these quality measures was not possible in the first
NHDR.)
Topic |
Measure |
National Databasea |
Health Insurance Coverage |
People
under 65 with health insuranceb |
NHIS |
People
under 65 with any private insurance |
NHIS |
People 65
and over with any private insurance |
NHIS |
People
under 65 with public insurance only |
NHIS |
People
uninsured all year |
MEPS |
People
with any period of public insurance during a year |
MEPS |
People
with any period of uninsurance during a year |
MEPS |
Usual Source of Care |
People
who have a specific source of ongoing careb |
NHIS |
People in
fair or poor health who have a specific source of ongoing care |
NHIS |
People
with hospital, emergency room, or clinic as a source of ongoing care |
NHIS |
People
without a usual source of care who indicate a financial or insurance reason
for not having a source of care |
MEPS |
People
who have a usual primary care providerb |
MEPS |
Adults
with community health center as usual source of care |
Commonwealth |
Adults
who report very little or no choice in source of care |
Commonwealth |
Adults
who have not had their regular doctor for more than 5 years |
Commonwealth |
Patient Perceptions of Need |
Families
that experience difficulties or delays in obtaining health care or do not
receive needed careb |
MEPS |
Families
that experience difficulties or delays in obtaining health care due to
financial or insurance reasons |
MEPS |
Families
that did not receive a doctor's care or prescription medications because the
family needed the money |
MEPS |
Families
not very satisfied that they can get health care if they need it |
MEPS |
Adults who
can always get appointments for routine care as soon as wanted |
MEPS |
Adults
who can always get care for illness or injury as soon as wanted |
MEPS |
Topic |
Measure |
National Databasea |
Patient-Provider Communication |
People
with provider who generally listens and gives needed information about
health/health care |
MEPS |
People
with provider who usually asks about
medications and treatments other doctors may give |
MEPS |
Adults
whose providers always listened carefully to them |
MEPS |
Adults
whose providers always explained things in a way they could understand |
MEPS |
Adults
whose providers always showed respect for what they had to say |
MEPS |
Adults
with one or more indicators of poor communication at their last visit |
Commonwealth |
Patient-Provider Relationship |
People
not satisfied with quality of care received from provider |
MEPS |
People
not confident in provider's help when they have a medical problem |
MEPS |
Adults
whose providers always spent enough time with them |
MEPS |
Adults
who rate their health care on a scale from 0-10 (0-6, 7-8, 9-10) |
MEPS |
Adults
not treated with a great deal of dignity and respect |
Commonwealth |
Adults
not involved as much as wanted in decisionmaking |
Commonwealth |
Adults
with not as much time as wanted with doctor |
Commonwealth |
Adults
with incident in past 2 years when they did not follow doctor's advice |
Commonwealth |
Adults
who report that they or a family member got sick due to doctor or hospital
mistake |
Commonwealth |
Cultural Competency |
Adults
who believe they would have gotten better care if different race/ethnicity |
Commonwealth |
Adults
who felt treated with disrespect because of race/ethnicity |
Commonwealth |
Adults
who do not strongly agree that doctor understands background and values |
Commonwealth |
Health Information |
Adults
who did not find prescription bottle very easy to understand |
Commonwealth |
Adults
who did not find information from doctor's office very easy to understand |
Commonwealth |
Adults
who do not use Web for health information |
Commonwealth |
Adults
who do not use printed material for health information |
Commonwealth |
Adults who do not call their doctor for health
information |
Commonwealth |
Topic |
Measure |
National Databasea |
Overall
Utilization |
People
with office or outpatient visit |
MEPS |
People
with prescription medications |
MEPS |
People
with dental visit |
MEPS |
People
with emergency room visit |
MEPS |
People
with inpatient discharge |
MEPS |
People
with home health visit |
MEPS |
Care in Doctors' Offices and Hospital Outpatient
Departments |
Outpatient
visits per 100 population |
NAMCS/NHAMCS-OPD |
Outpatient
visits where patient was seen before in clinic or practice |
NAMCS/NHAMCS-OPD |
Outpatient
visits where patient was seen by patient's primary care provider |
NAMCS/NHAMCS-OPD |
Outpatient
visits where patient was seen for non-illness care |
NAMCS/NHAMCS-OPD |
Outpatient
visits with counseling or education about diet or nutrition |
NAMCS/NHAMCS-OPD |
Outpatient
visits with counseling or education about exercise |
NAMCS/NHAMCS-OPD |
Outpatient
visits with counseling or education about tobacco use and exposure |
NAMCS/NHAMCS-OPD |
Outpatient
visits where physician spent >30 minutes with patient |
NAMCS/NHAMCS-OPD |
Referred Care |
Outpatient
visits where patient was referred by another physician or by a health plan |
NAMCS/NHAMCS-OPD |
Outpatient
visits where patient was referred to another physician |
NAMCS/NHAMCS-OPD |
Mental Health Care and Substance Abuse Treatment |
Adults
who received mental health treatment or counseling in the past year |
NHSDA |
Adults
who received outpatient mental health treatment or counseling |
NHSDA |
Adults
who received prescription medications for mental health treatment |
NHSDA |
Adults
who received inpatient mental health treatment or counseling |
NHSDA |
Adults
with serious mental illness who received
mental health treatment or counseling |
NHSDA |
People 12
and older who received illicit drug or alcohol abuse treatment in the past
year |
NHSDA |
People 12
and older who needed treatment at a specialty facility for illicit drug use
and who received such treatment in the past year |
NHSDA |
Inpatient
admissions to specialty mental health organizations per 100,000 population |
CPSS |
Residential
care admissions to specialty mental health organizations per 100,000
population |
CPSS |
<24
hour care admissions to specialty mental health organizations per 100,000
population |
CPSS |
HIV Care |
Hospitalizations
for HIV per 10,000 population |
NHDS |
HIV
patients with 4 or more ambulatory
visits in the past year |
HIV
Research Network |
HIV
patients with CD4 <50 with 4 or
more ambulatory visits in the past year |
HIV
Research Network |
HIV
patients with inpatient hospitalization in the past year |
HIV
Research Network |
HIV
patients with CD4 <50 with inpatient hospitalization in the past year |
HIV
Research Network |
Emergency Care |
Emergency
department visits per 100 population |
NHAMCS-ED |
Emergency
department visits for injury or poisoning per 10,000 population |
NHAMCS-ED |
Emergency
department visits for asthma per 10,000 populationb
|
NHAMCS-ED |
Emergency
department visits where patient was seen by intern/resident only |
NHAMCS-ED |
Inpatient
Care |
Total
hospitalizations per 100 population |
NHDS |
Avoidable admissions for hypertension per 100,000
population 18 and older |
HCUP SID |
Avoidable admissions for angina per 100,000 population 18
and older |
HCUP SID |
Avoidable admissions for COPD per 100,000 population 18
and older |
HCUP SID |
Avoidable admissions for bacterial pneumonia per
100,000 population |
HCUP SID |
Perforated appendices per 1,000 admissions with
appendicitis |
HCUP SID |
Admissions for PTCA per 100,000 population 40 and older |
HCUP SID |
Admissions for coronary artery bypass graft surgery per
100,000 population 40 and older |
HDUP SID |
Admissions for hysterectomy per 100,000 female
population 18 and older |
HCUP SID |
Admissions
for laminectomy or spinal fusion per 100,000
population 18 and older |
HCUP SID |
Cesarean
deliveries per 1,000 deliveries |
HCUP SID |
Vaginal
births per 1,000 women with previous cesarean deliveries |
HCUP SID |
Chronic Care |
Adult
home health care discharges per 10,000 population |
NHHCS |
Adult
nursing home discharges per 10,000 population |
NNHS |
Adult
nursing home discharges who received at least one rehabilitative service |
NNHS |
Adult
nursing home discharges who received mental health services |
NNHS |
Adult
nursing home discharges who were discharged either recovered or stabilized |
NNHS |
Hospice
discharges per 100,000 population |
NHHCS |