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Chapter 3. Quality of Health Care (continued)
Tables 1-11
Table 1. Racial and Ethnic Differences in Effectiveness of Care: Cancer
| Measure |
Racial Differencei |
Ethnic Differenceii |
| Black |
Asian |
NHOPI |
AI/AN |
>1 Race |
NHB |
Hispanic |
| Screening for Breast Cancer |
| % of women (40 and over) who report they had a mammogram within the past 2 yearsiii |
 |
 |
 |
 |
 |
 |
 |
| % of breast cancers diagnosed at late stageiv |
 |
 |
 |
 |
|
 |
 |
| Screening for Cervical Cancer |
| % of women (18 and over) who report they had a Pap smear within the past 3 yearsiii |
 |
 |
 |
 |
 |
 |
 |
| % of cervical cancers diagnosed at late stageiv |
 |
 |
 |
 |
|
 |
 |
| Screening for Colorectal Cancer |
| % of men and women (50 and over) who report they ever had a flexible sigmoidoscopy/colonoscopyiii |
 |
 |
 |
 |
 |
 |
 |
| % of men and women (50 and over) who report they had a fecal occult blood test (FOBT) within the past 2 yearsiii |
 |
 |
 |
 |
 |
 |
 |
| % of colorectal cancers diagnosed at late stageiv |
 |
 |
 |
 |
|
 |
 |
| Cancer Treatmentv |
| Cancer deaths per 100,000 persons per year for all cancers |
 |
v |
 |
|
 |
 |
| Cancer deaths per 100,000 persons per year for most common cancers, prostate cancer |
 |
v |
 |
|
 |
 |
| Cancer deaths per 100,000 persons per year for most common cancers, breast cancer |
 |
v |
 |
|
 |
 |
| Cancer deaths per 100,000 persons per year for most common cancers, lung cancer |
 |
v |
 |
|
 |
 |
| Cancer deaths per 100,000 persons per year for most common cancers, colorectal cancer |
 |
v |
 |
|
 |
 |
| Palliative Carevi |
| % of people who died of cancer who received hospice care |
vi |
|
|
|
|
|
|
| Median length of stay for cancer patients who received hospice care |
vi |
|
|
|
|
|
|
i Compared with whites.
ii Compared with non-Hispanic whites.
iii Source: NHIS, 2000.
iv Source: SEER, 1998-1999. This source did not collect information for >1 race.
v Source: NVSS-M, 2000. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asians or Pacific Islanders. This source did not collect information for >1 race.
vi Source: NHHCS, 2000. Sample size constraints permit black-white comparisons only.
NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian/Alaska Native; HS=high school
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
Table 2. Socioeconomic Differences in Effectiveness of Care: Cancer
| Measure |
Income Differencei |
Educational Differenceii |
Insurance Differenceiii |
| <100% |
100-199% |
200-399% |
<HS |
HS Grad |
Uninsured |
| Screening for Breast Cancer |
| % of women (40 and over) who report they had a mammogram within the past 2 yearsiv |
 |
 |
 |
 |
 |
 |
| Screening for Cervical Cancer |
| % of women (18 and over) who report they had a Pap smear within the past 3 yearsiv |
 |
 |
 |
 |
 |
 |
| Screening for Colorectal Cancer |
| % of men and women (50 and over) who report they ever had a flexible sigmoidoscopy/colonoscopyiv |
 |
 |
 |
 |
 |
 |
| % of men and women (50 and over) who report they had a fecal occult blood test (FOBT) within the past 2 yearsiv |
 |
 |
 |
 |
 |
 |
| Cancer Treatmentv |
| Cancer deaths per 100,000 persons per year for all cancers |
|
|
|
 |
 |
|
| Cancer deaths per 100,000 persons per year for most common cancers, prostate cancer |
|
|
|
 |
 |
|
| Cancer deaths per 100,000 persons per year for most common cancers, breast cancer |
|
|
|
 |
 |
|
| Cancer deaths per 100,000 persons per year for most common cancers, lung cancer |
|
|
|
 |
 |
|
| Cancer deaths per 100,000 persons per year for most common cancers, colorectal cancer |
|
|
|
 |
 |
|
i Compared with persons with family incomes 400% of Federal poverty threshold or above.
ii Compared with persons with any college education.
iii Compared with person under 65 with any private health insurance.
iv Source: NHIS, 2000.
v Source: NVSS-M, 2000. This source did not collect information for >1 race. This source did not collect information on income or insurance.
NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian or Alaska Native; NHB=Non-Hispanic black; HS=High school
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
Table 3. Racial and Ethnic Differences in Effectiveness of Care: Chronic Kidney Disease
| Measure |
Racial Differencei |
Ethnic Differenceii |
| Black |
Asian |
NHOPI |
AI/AN |
>1 Race |
NHB |
Hispanic |
| Management of End-Stage Renal Diseaseiii |
| % of hemodialysis patients with urea reduction ratio 65% or higher |
 |
 |
 |
 |
|
 |
 |
| % of hemodialysis patients with hemoglobin 11 or higher |
 |
 |
 |
 |
|
 |
 |
| Renal Transplantationiv |
| % of dialysis patients registered on the waiting list for transplantation |
 |
4 |
 |
|
 |
 |
| % of patients with treated chronic kidney failure who receive a transplant within 3 years of registration on the waiting list |
 |
4 |
 |
|
 |
 |
i Compared with whites.
ii Compared with non-Hispanic whites.
iii Source: CMS's End Stage Renal Disease Clinical Performance Measures Project, 2001. This source did not collect information for >1 race.
iv USRDS, 2000. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asians or Pacific Islanders. This source did not collect information for >1 race.
NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian/Alaska Native; HS=high school
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
Table 4. Racial and Ethnic Differences in Effectiveness of Care: Diabetes
| Measure |
Racial Differencei |
Ethnic Differenceii |
| Black |
Asian |
NHOPI |
AI/AN |
>1 Race |
NHB |
Hispanic |
| Management of Diabetes |
| % of adults with diabetes who had a hemoglobin A1c measurement at least once in past yeariii |
 |
iii |
 |
|
 |
 |
| % of adults with diabetes who had a lipid profile in past two yearsiii |
 |
iii |
 |
|
 |
 |
| % of adults with diabetes who had a retinal eye examination in past yeariii |
 |
iii |
 |
|
 |
 |
| % of adults with diabetes who had a foot examination in past yeariii |
 |
iii |
 |
|
 |
 |
| % of adults with diabetes who had an influenza immunization in past yeariii |
 |
iii |
 |
|
 |
 |
| Hospital admissions for uncontrolled diabetes per 100,000 populationiv |
*iv |
iv |
|
|
 |
 |
| Hospital admissions for short term complications of diabetes per 100,000 populationiv |
*iv |
iv |
|
|
 |
 |
| Hospital admissions for long term complications of diabetes per 100,000 populationiv |
*iv |
iv |
|
|
 |
 |
| Hospital admissions for lower extremity amputations in patients with diabetes per 1,000 populationv |
 |
 |
 |
 |
|
|
|
i Compared with whites.
ii Compared with non-Hispanic whites.
iii Source: MEPS, 2000. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asians or Pacific Islanders. This source did not collect information for >1 race.
iv Source: HCUP SID 16 State database, 2000. This source categorizes race/ethnicity very differently from other sources. Race/ethnicity information is categorized as a single item: non-Hispanic white, non-Hispanic black, Hispanic, Asian or Pacific Islander. These contrasts compare each group with non-Hispanic whites. An * is inserted in the black column to indicate that estimates for this group could not be produced.
v Source: NHDS, 1998-2000. This source did not collect information for >1 race. Missing rates preclude analysis by ethnicity.
NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian/Alaska Native; HS=high school
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
Table 5. Socioeconomic Differences in Effectiveness of Care: Diabetes
| Measure |
Income Differencei |
Educational Differenceii |
Insurance Differenceiii |
| <100% |
100-199% |
200-399% |
<HS |
HS Grad |
Uninsured |
| Management of Diabetes |
| % of adults with diabetes who had a hemoglobin A1c measurement at least once in past yeariii |
 |
 |
 |
 |
 |
 |
| % of adults with diabetes who had a lipid profile in past two yearsiii |
 |
 |
 |
 |
 |
 |
| % of adults with diabetes who had a retinal eye examination in past yeariii |
 |
 |
 |
 |
 |
 |
| % of adults with diabetes who had a foot examination in past yeariii |
 |
 |
 |
 |
 |
 |
| % of adults with diabetes who had an influenza immunization in past yeariii |
 |
 |
 |
 |
 |
 |
i Compared with persons with family incomes 400% of Federal poverty threshold or above.
ii Compared with persons with any college education.
iii Compared with person under 65 with any private health insurance.
HS=high school
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
Table 6. Racial and Ethnic Differences in Effectiveness of Care: Heart Disease
| Measure |
Racial Differencei |
Ethnic Differenceii |
| Black |
Asian |
NHOPI |
AI/AN |
>1 Race |
NHB |
Hispanic |
| Screening for High Blood Pressure |
| % of adults who have had their blood pressure measured within the preceding 2 years and can state whether their blood pressure was normal or highiii |
 |
 |
 |
 |
 |
 |
 |
| Screening for High Cholesterol |
| % of adults who have had their blood cholesterol checked within the preceding 5 years3 |
 |
 |
 |
 |
 |
 |
 |
| Counseling on Risk Factors |
| % of smokers receiving advice to quit smokingiv |
 |
iv |
 |
|
 |
 |
| Treatment of Acute Myocardial Infarctionv |
| % of AMI patients administered aspirin within 24 hours of admission |
*v |
v |
 |
|
 |
 |
| % of AMI patients with aspirin prescribed at discharge |
*v |
v |
 |
|
 |
 |
| % of AMI patients administered beta blocker within 24 hours of admission |
*v |
v |
 |
|
 |
 |
| % of AMI patients with beta blocker prescribed at discharge |
*v |
v |
 |
|
 |
 |
| % of AMI patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge |
*v |
v |
 |
|
 |
 |
| % of AMI patients given smoking cessation counseling while hospitalized |
*v |
v |
 |
|
 |
 |
| Treatment of Acute Heart Failure |
| % of heart failure patients with left ventricular systolic dysfunction prescribed ACE inhibitor at dischargev |
*v |
v |
 |
|
 |
 |
| Management of Hypertension |
| % of adults with hypertension whose blood pressure is under controlvi |
 |
 |
 |
 |
|
 |
 |
| Management of Congestive Heart Failure |
| Hospital admissions for congestive heart failure per 100,000 populationvii |
 |
 |
 |
 |
|
|
|
i Compared with whites.
ii Compared with non-Hispanic whites.
iii Source: NHIS, 1998.
iv Source: MEPS, 2000. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asians or Pacific Islanders. This source did not collect information for >1 race.
v Source: Medicare Quality Improvement Organization program. This source categorizes race/ethnicity very differently from other sources. Race/ethnicity information is categorized as a single item: non-Hispanic white, Non-Hispanic black, Hispanic, Asian or Pacific Islander. These contrasts compare each group with non-Hispanic whites. An * is inserted in the Black column to indicate that estimates for this group could not be produced.
vi Source: NHANES, 1999-2000.
vii Source: NHDS, 2000. This source did not collect information for >1 race. Missing rates preclude analysis by ethnicity.
NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian/Alaska Native; HS=high school
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
Table 7. Socioeconomic Differences in Effectiveness of Care: Heart Disease
| Measure |
Income Differencei |
Educational Differenceii |
Insurance Differenceiii |
| <100% |
100-199% |
200-399% |
<HS |
HS Grad |
Uninsured |
| Screening for High Blood Pressure |
| % of adults who have had their blood pressure measured within the preceding 2 years and can state whether their blood pressure was normal or highiv |
 |
 |
 |
 |
 |
 |
| Screening for High Cholesterol |
| % of adults who have had their blood cholesterol checked within the preceding 5 yearsiv |
 |
 |
 |
 |
 |
 |
| Counseling on Risk Factors |
| % of smokers receiving advice to quit smokingv |
 |
 |
 |
 |
 |
 |
| Management of Hypertension |
| % of adults with hypertension whose blood pressure is under controlvi |
 |
 |
 |
 |
 |
|
i Compared with persons with family incomes 400% of Federal poverty threshold or above.
ii Compared with persons with any college education.
iii Compared with person under 65 with any private health insurance.
iv Source: NHIS, 1998.
v Source: MEPS, 2000.
vi Source: NHANES, 1999-2000.
HS=high school
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
Table 8. Racial and Ethnic Differences in Effectiveness of Care: HIV/AIDS
| Measure |
Racial Differencei |
Ethnic Differenceii |
| Black |
Asian |
NHOPI |
AI/AN |
>1 Race |
NHB |
Hispanic |
| AIDS Prevention |
| New AIDS cases per 100,000 population 13 and overiii |
*iii |
iii |
 |
|
 |
 |
| Management of HIV/AIDS |
| HIV-infection deaths per 100,000 populationiv |
 |
iv |
 |
|
 |
 |
i Compared with whites.
ii Compared with non-Hispanic whites.
iii Source: CDC, 2000. This source categorizes race/ethnicity very differently from other sources. Race/ethnicity information is categorized as a single item: non-Hispanic white, non-Hispanic black, Hispanic, Asians or Pacific Islanders. These contrasts compare each group with non-Hispanic whites. An * is inserted in the black column to indicate that estimates for this group could not be produced.
iv Source: NVSS-M, 2000. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian or Pacific Islander. This source did not collect information for >1 race.
NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian/Alaska Native; HS=high school
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
Table 9. Socioeconomic Differences in Effectiveness of Care: HIV/AIDS
| Measure |
Income Differencei |
Educational Differenceii |
Insurance Differenceiii |
| <100% |
100-199% |
200-399% |
<HS |
HS Grad |
Uninsured |
| Management of HIV/AIDS |
| HIV-infection deaths per 100,000 population |
|
|
|
 |
 |
|
i Compared with persons with family incomes 400% of Federal poverty threshold or above.
ii Compared with persons with any college education.
iii Compared with persons under 65 with any private health insurance.
Source: NVSS-M, 2000.
HS=high school
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
Table 10. Racial and Ethnic Differences in Effectiveness of Care: Maternal and Child Health
| Measure |
Racial Differencei |
Ethnic Differenceii |
| Black |
Asian |
NHOPI |
AI/AN |
>1 Race |
NHB |
Hispanic |
| Maternity Careiii |
| % of pregnant women receiving prenatal care in first trimester |
 |
 |
 |
 |
|
 |
 |
| % of live born infants with low birth weight (<2500 grams) |
 |
 |
 |
 |
|
 |
 |
| % of live born infants with very low birth weight (<1500 grams) |
 |
 |
 |
 |
|
 |
 |
| Infant mortality per 1000 live births, all |
 |
 |
 |
 |
|
 |
 |
| Infant mortality per 1000 live births, birth weight >2499 grams |
 |
 |
 |
 |
|
 |
 |
| Infant mortality per 1000 live births, birth weight 1500-2499 grams |
 |
 |
 |
 |
|
 |
 |
| Infant mortality per 1000 live births, birth weight <1500 grams |
 |
 |
 |
 |
|
 |
 |
| Maternal deaths per 100,000 live births |
 |
 |
 |
 |
|
 |
 |
| Immunization, Childhoodiv |
| % of children 19-35 months who received all recommended vaccines |
 |
 |
 |
 |
 |
 |
 |
| % of children 19-35 months who received 4 doses of DPaT vaccine |
 |
 |
 |
 |
 |
 |
 |
| % of children 19-35 months who received 3 doses of polio vaccine |
 |
 |
 |
 |
 |
 |
 |
| % of children 19-35 months who received 1 dose of MMR vaccine |
 |
 |
 |
 |
 |
 |
 |
| % of children 19-35 months who received 3 doses of Hib vaccine |
 |
 |
 |
 |
 |
 |
 |
| % of children 19-35 months who received 3 doses of hepatitis B vaccine |
 |
 |
 |
 |
 |
 |
 |
| % of children 19-35 months who received 1 dose of varicella vaccine |
 |
 |
 |
 |
 |
 |
 |
| Immunization, Adolescentv |
| % of adolescents (13-15) who received 3 or more doses of hepatitis B vaccine |
 |
 |
 |
 |
 |
 |
 |
| % of adolescents (13-15) who received 2 or more doses of MMR vaccine |
 |
 |
 |
 |
 |
 |
 |
| % of adolescents (13-15) who received 1 or more doses of Td booster |
 |
 |
 |
 |
 |
 |
 |
| % of adolescents (13-15) who received 3 or more doses of varicella vaccine |
 |
 |
 |
 |
 |
 |
 |
| Childhood Dental Care |
| % of children 2-17 with a dental visitvi |
 |
vi |
 |
|
 |
 |
i Compared with whites.
ii Compared with non-Hispanic whites.
iii Source: NVSS, 2000. This source did not collect information for >1 race.
iv Source: NIS, 2001.
v Source: NHIS, 2000.
vi Source: MEPS, 1999. This source did not collect information on Asians and NHOPIs separately but in aggregate. This source did not collect information for >1 race.
NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian/Alaska Native; HS=high school
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
Table 10. Racial and Ethnic Differences in Effectiveness of Care: Maternal and Child Health (continued)
| Measure |
Racial Differencei |
Ethnic Differenceii |
| Black |
Asian |
NHOPI |
AI/AN |
>1 Race |
NHB |
Hispanic |
| Treatment of Pediatric Gastroenteritis |
| Hospital admissions for pediatric gastroenteritis per 100,000 populationiii |
*iii |
iii |
|
|
 |
 |
i Compared with whites.
ii Compared with non-Hispanic whites.
iii Source: HCUP SID 16 State database, 2000. This source categorizes race/ethnicity very differently from other sources. Race/ethnicity information is categorized as a single item: Non-Hispanic white, Non-Hispanic black, Hispanic, Asian or Pacific Islander. These contrasts compare each group with non-Hispanic whites. An * is inserted in the Black column to indicate that estimates for this group could not be produced.
NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian/Alaska Native; HS=high school
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
Table 11. Socioeconomic Differences in Effectiveness of Care: Maternal and Child Health
| Measure |
Income Differencei |
Educational Differenceii |
Insurance Differenceiii |
| <100% |
100-199% |
200-399% |
<HS |
HS Grad |
Uninsured |
| Maternity Careiv |
| % of pregnant women receiving prenatal care in first trimester |
|
|
|
 |
 |
|
| % of live born infants with low birth weight (<2500 grams) |
|
|
|
 |
 |
|
| % of live born infants with very low birth weight (<1500 grams) |
|
|
|
 |
 |
|
| Infant mortality per 1000 live births, all births |
|
|
|
 |
 |
|
| Infant mortality per 1000 live births, birth weight >2499 grams |
|
|
|
 |
 |
|
| Infant mortality per 1000 live births, birth weight 1500-2499 grams |
|
|
|
 |
 |
|
| Infant mortality per 1000 live births, birth weight <1500 grams |
|
|
|
 |
 |
|
| Maternal deaths per 100,000 live births |
|
|
|
 |
 |
|
| Immunization, Childhoodv |
| % of children 19-35 months who received all recommended vaccines |
 |
 |
 |
|
|
|
| % of children 19-35 months who received 4 doses of DPaT vaccine |
 |
 |
 |
|
|
|
| % of children 19-35 months who received 3 doses of polio vaccine |
 |
 |
 |
|
|
|
| % of children 19-35 months who received 1 dose of MMR vaccine |
 |
 |
 |
|
|
|
| % of children 19-35 months who received 3 doses of Hib vaccine |
 |
 |
 |
|
|
|
| % of children 19-35 months who received 3 doses of hepatitis B vaccine |
 |
 |
 |
|
|
|
| % of children 19-35 months who received 1 dose of varicella vaccine |
 |
 |
 |
|
|
|
| Immunization, Adolescentvi |
| % of adolescents (13-15) who received 3 or more doses of hepatitis B vaccine |
 |
 |
 |
|
|
 |
| % of adolescents (13-15) who received 2 or more doses of MMR vaccine |
 |
 |
 |
|
|
 |
| % of adolescents (13-15) who received 1 or more doses of tetanus-diptheria booster |
 |
 |
 |
|
|
 |
| % of adolescents (13-15) who received 3 or more doses of varicella vaccine |
 |
 |
 |
|
|
 |
| Childhood Dental Care |
| % of children 2-17 with a dental visit in the past yearvii |
 |
 |
 |
|
|
 |
i Compared with persons with family incomes 400% of Federal poverty threshold or above.
ii Compared with mothers with any college education.
iii Compared with person under 65 with any private health insurance.
iv Source: NVSS, 2000.
v Source: NIS, 2001.
vi Source: NHIS, 2000.
vii Source: MEPS, 1999.
Key to Quality of Health Care Tables:
: Selected population and comparison population receive about same quality of health care
: Selected population receives better quality care than the comparison population
: Selected population receives worse quality care than the comparison population
: Data are collected but do not meet criteria for statistical reliability
Return to Contents
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