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National Healthcare Disparities Report, 2007

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Effectiveness of Care: Heart Disease


Screening for High Blood Pressure
Adults who have had their blood pressure measured within the preceding 2 years and can state whether their blood pressure was normal or high
Screening for High Cholesterol
Adults who have had their blood cholesterol checked within the preceding 5 years
Counseling on Risk Factors
Current smokers age 18 and over receiving advice to quit smoking
Treatment of Acute Myocardial Infarction
Composite measure: Patients with acute myocardial infarction (AMI) who received all recommended hospital care for AMI (administered aspirin and beta blocker within 24 hours of admission, prescribed aspirin and beta blocker at discharge, and given smoking cessation counseling while hospitalized)
Acute myocardial infarction (AMI) patients administered aspirin within 24 hours of admission
Acute myocardial infarction (AMI) patients with aspirin prescribed at discharge
Acute myocardial infarction (AMI) patients administered beta blocker within 24 hours of admission
Acute myocardial infarction (AMI) patients with beta blocker prescribed at discharge
Acute myocardial infarction (AMI) patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge
Acute myocardial infarction (AMI) patients given smoking cessation counseling while hospitalized
Treatment of Acute Heart Failure
Composite measure: Heart failure patients who received all recommended hospital care for heart failure (having evaluation of left ventricular ejection fraction and prescribed ACE inhibitor or ARB at discharge, if indicated, for left ventricular systolic dysfunction)
Heart failure patients having evaluation of left ventricular ejection fraction
Heart failure patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge
Management of Congestive Heart Failure
Hospital admissions for congestive heart failure per 100,000 population
Inpatient Mortality for Cardiovascular Conditions and Procedures
Deaths per 1,000 adult admissions with acute myocardial infarction
Deaths per 1,000 adult admissions with congestive heart failure
Deaths per 1,000 adult admissions with coronary artery bypass surgery, age 40 and over
Deaths per 1,000 adult admissions with percutaneous transluminal coronary angioplasty, age 40 and over
Deaths per 1,000 admissions with abdominal aortic aneurysm repair
Deaths per 1,000 pediatric heart surgery admissions, under age 18
Management of Hypertension
Percent of people with hypertension who have blood pressure under control
Preventive Care
Noninstitutionalized adults who were obese who were told by a doctor they were overweight
Noninstitutionalized adults who were obese who were given advice about exercise
Noninstitutionalized adults who were obese who were given advice about eating fewer high fat or high cholesterol foods

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Screening for High Blood Pressure

Measure Title

Adults who have had their blood pressure measured within the preceding 2 years and can state whether their blood pressure was normal or high.

Measure Source

Healthy People 2010.

Table

Data source does not support detailed table.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).

Denominator

U.S. resident population age 18 and over.

Numerator

Number of adults age 18 and over who had their blood pressure measured within the preceding 2 years and could state blood-pressure level.

Comments

This measure is referred to as measure 12-12 in Healthy People 2010 documentation.

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Screening for High Cholesterol

Measure Title

Adults who have had their blood cholesterol checked within the preceding 5 years.

Measure Source

Healthy People 2010.

Table

Data source does not support detailed table.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).

Denominator

U.S. resident population age 18 and over.

Numerator

U.S. adult population age 18 and over who have had their cholesterol checked within 5 years.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

This measure is referred to as measure 12-15 in Healthy People 2010 documentation.

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Counseling on Risk Factors

Measure Title

Current smokers age 18 and over receiving advice to quit smoking.

Measure Source

Healthy People 2010.

Tables

41 Adult smokers receiving advice to quit smoking, United States, 2004, by

  • Race.
  • Ethnicity.
  • Family income.
  • Education.

Data Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Denominator

Adults age 18 and older who reported in the study year that they currently smoke and had a routine checkup and answered the question: "In the past 12 months did a doctor advise you to stop smoking?"

Numerator

Subset of the denominator who indicated they had received advice to quit smoking.

Comments

The allowable responses to the MEPS survey question about smoking changed in 2003. Therefore, reported national rates may not be comparable with earlier years.

Nonresponses and "Don't know" responses were excluded from the analysis.

This measure is referred to as measure 1-3c in Healthy People 2010 documentation.

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Treatment of Acute Myocardial Infarction

Measure Title

Composite measure: Patients with acute myocardial infarction (AMI) who received all recommended hospital care for AMI (administered aspirin and beta blocker within 24 hours of admission, prescribed aspirin and beta blocker at discharge, and given smoking cessation counseling while hospitalized).

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Table

42 Percent of AMI patients who received recommended hospital care, all payers, United States, 2005

Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

Denominator

Medicare hospital discharges with a principal diagnosis of AMI and a history of smoking cigarettes anytime during the year prior to hospital arrival.

Numerator

Subset of AMI denominator patients who received all recommended processes during the hospital stay: aspirin and beta blocker administered within 24 hours of admission, aspirin and beta blocker prescribed at discharge, and smoking cessation counseling given while hospitalized.

Comments

ICD-9-CM codes for AMI include 410.01, 410.11, 410.21, 410.31, 410.41, 410.51, 410.61, 410.71, 410.81, and 410.91. The measure specifies exclusion of patients under age 18, patients transferred to another acute care or Federal hospital, patients transferred to hospice, patients who expired, and patients who left against medical advice. Further information on this and other heart disease measures is available at http://www.cms.hhs.gov/QualityInitiativesGenInfo/.

This measure and its tables are also presented in other relevant sections of the report.

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Treatment of Acute Myocardial Infarction

Measure Title

Acute myocardial infarction (AMI) patients administered aspirin within 24 hours of admission.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Table

43 Percent of AMI patients administered aspirin within 24 hours of admission, all payers, United States, 2005

Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

Denominator

Medicare discharges age 18 and over with a principal diagnosis of AMI (ICD-9-CM codes 410.00, 410.01, 410.10, 410.11, 410.20, 410.21, 410.30, 410.31, 410.40, 410.41, 410.50, 410.51, 410.60, 410.61, 410.70, 410.71, 410.80, 410.81, 410.90, 410.91). Excludes patients transferred to another acute care hospital on day of arrival; patients received in transfer from another hospital, including another emergency department; patients discharged on day of arrival; and patients who expired on day of arrival. Excludes patients with one or more of the following aspirin contraindications documented in the medical record: bleeding on admission, aspirin allergy, history of internal bleeding or bleeding/coagulation disorder, chronic liver disease, platelet count < 100 x 109/L on admission, anemia, treatment with warfarin prior to admission, history of peptic ulcer disease, and admission serum creatinine >3 mg/dL.

Numerator

Subset of the AMI denominator patients who received aspirin within 24 hours before or after hospital arrival.

Comments

This measure is also a Joint Commission on Accreditation of Healthcare Organizations core measure.

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Treatment of Acute Myocardial Infarction

Measure Title

Acute myocardial infarction (AMI) patients with aspirin prescribed at discharge.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Table

44 Percent of AMI patients with aspirin prescribed at discharge, all payers, United States, 2005

Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

Denominator

Medicare discharges age 18 and over with a principal diagnosis of AMI (ICD-9-CM codes 410.00, 410.01, 410.10, 410.11, 410.20, 410.21, 410.30, 410.31, 410.40, 410.41, 410.50, 410.51, 410.60, 410.61, 410.70, 410.71, 410.80, 410.81, 410.90, 410.91). Excludes patients transferred to another acute care hospital, patients who expired, patients discharged to hospice, and patients who had unknown discharge status. Excludes patients with one or more of the following aspirin contraindications documented in the medical record: aspirin allergy, bleeding on admission, reaction to aspirin during admission, history of internal bleeding or bleeding/coagulation disorder, hemorrhage/bleed during hospital stay, chronic liver disease, admission platelet count < 100 x 109/L, anemia, admission or highest serum creatinine level > 3 mg/dL, history of peptic ulcer disease, acute upper gastrointestinal disorder during hospital stay, and treatment with warfarin at discharge.

Numerator

Subset of the AMI denominator patients prescribed aspirin at hospital discharge.

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Treatment of Acute Myocardial Infarction

Measure Title

Acute myocardial infarction (AMI) patients administered beta blocker within 24 hours of admission.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Table

45 Percent of AMI patients administered beta blocker within 24 hours of admission, all payers, United States, 2005

Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

Denominator

Medicare discharges age 18 and over with a principal diagnosis of AMI (ICD-9-CM codes 410.00, 410.01, 410.10, 410.11, 410.20, 410.21, 410.30, 410.31, 410.40, 410.41, 410.50, 410.51, 410.60, 410.61, 410.70, 410.71, 410.80, 410.81, 410.90, 410.91). Excludes patients transferred to another acute care hospital on day of arrival; patients received in transfer from another hospital, including another emergency department; patients discharged on day of arrival; patients who expired on day of arrival; and patients of unknown source of admission. Excludes patients with one or more of the following beta blocker contraindications documented in the medical record: beta blocker allergy; bradycardia (heart rate less than 60 bpm) on admission while not on a beta blocker; systolic blood pressure < 100 mm Hg on admission; heart failure or shock on admission; PR interval > .24 seconds; second or third degree heart block or bifascicular block on admission ECG; history of chronic obstructive pulmonary disease, heart failure, asthma, or peripheral vascular disease; previous left ventricular ejection fraction < 50 or described as depressed to any degree.

Numerator

Subset of the AMI denominator patients who received a beta blocker within 24 hours after hospital arrival.

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Treatment of Acute Myocardial Infarction

Measure Title

Acute myocardial infarction (AMI) patients with beta blocker prescribed at discharge.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Table

46 Percent of AMI patients with beta blocker prescribed at discharge, all payers, United States, 2005

Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

Denominator

Medicare discharges age 18 and over with a principal diagnosis of AMI (ICD-9-CM 410.00, 410.01, 410.10, 410.11, 410.20, 410.21, 410.30, 410.31, 410.40, 410.41, 410.50, 410.51, 410.60, 410.61, 410.70, 410.71, 410.80, 410.81, 410.90, 410.91). Excludes patients transferred to another acute care hospital on day of arrival; patients received in transfer from another hospital, including another emergency department; patients discharged on day of arrival; patients who expired on day of arrival; and patients of unknown source of admission. Excludes patients with one or more of the following beta blocker contraindications documented in the medical record: beta blocker allergy; bradycardia (heart rate less than 60 bpm) on admission while not on a beta blocker; systolic blood pressure < 100 mm Hg on admission; heart failure or shock on admission; PR interval > .24 seconds; second or third degree heart block or bifascicular block on admission ECG; history of chronic obstructive pulmonary disease, heart failure, asthma, or peripheral vascular disease; previous left ventricular ejection fraction < 50 or described as depressed to any degree.

Numerator

AMI patients prescribed a beta blocker at hospital discharge.

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Treatment of Acute Myocardial Infarction

Measure Title

Acute myocardial infarction (AMI) patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Table

47 Percent of AMI patients with left ventricular systolic dysfunction prescribed ACE inhibitor or angiotensin receptor blocker at discharge, all payers, United States, 2005

Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

Denominator

Medicare discharges age 18 and over with a principal diagnosis of AMI (ICD-9-CM 410.00, 410.01, 410.10, 410.11, 410.20, 410.21, 410.30, 410.31, 410.40, 410.41, 410.50, 410.51, 410.60, 410.61, 410.70, 410.71, 410.80, 410.81, 410.90, 410.91) and chart documentation of a left ventricular ejection fraction less than 40% or a narrative description of LVF consistent with moderate or severe systolic dysfunction. Excludes patients transferred to another acute care hospital, patients who expired, and patients with unknown discharge disposition. Excludes patients with one or more of the following ACE inhibitor contraindications documented in the medical record: ACE inhibitor allergy or reaction to ACE inhibitors during hospitalization; aortic stenosis; admission or highest serum creatinine > 2 mg/dL; last systolic BP < 100 mm Hg and not discharged on an ACE inhibitor.

Numerator

Subset of the denominator population prescribed an ACE inhibitor at hospital discharge.

Comments

Left ventricular systolic dysfunction is defined in this measure as chart documentation of a left ventricular ejection fraction less than 40% or a narrative description of left ventricular function consistent with moderate or severe systolic dysfunction.

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Treatment of Acute Myocardial Infarction

Measure Title

Acute myocardial infarction (AMI) patients given smoking cessation counseling while hospitalized.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Table

48 Percent of AMI patients given smoking cessation counseling while hospitalized, all payers, United States, 2005

Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

Denominator

Medicare discharges age 18 and over with a principal diagnosis of AMI (ICD-9-CM codes 410.00, 410.01, 410.10, 410.11, 410.20, 410.21, 410.30, 410.31, 410.40, 410.41, 410.50, 410.51, 410.60, 410.61, 410.70, 410.71, 410.80, 410.81, 410.90, 410.91) and a history of smoking cigarettes anytime during the year prior to hospital arrival. Excludes patients transferred to another acute care hospital, patients who expired, and patients with unknown discharge disposition.

Numerator

Subset of the AMI denominator patients who receive smoking cessation advice or counseling during the hospital stay.

Comments

A smoker is defined in this measure as someone who has smoked cigarettes anytime during the year prior to hospital arrival.

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Treatment of Acute Heart Failure

Measure Title

Composite measure: Heart failure patients who received all recommended hospital care for heart failure (having evaluation of left ventricular ejection fraction and prescribed ACE inhibitor or ARB at discharge, if indicated, for left ventricular systolic dysfunction).

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Table

49 Percent of heart failure patients who received recommended hospital care, all payers, United States, 2005

Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

Denominator

Medicare hospital live discharges with a principal diagnosis of heart failure and with left ventricular systolic dysfunction (LVSD) and without angiotensin converting enzyme (ACE) inhibitor contraindications.

Numerator

Subset of the denominator heart failure patients with documentation that left ventricular ejection fraction was assessed before arrival, during hospitalization, or was planned for after discharge and who are prescribed an ACE inhibitor at hospital discharge.

Comments

ICD-9-CM codes for heart failure include 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 428.0, 428.1, 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, and 428.9.

Effective November 2004, CMS revised the LVSD measure to incorporate newly recognized treatment. Reported rates may not be comparable with those reported in earlier editions of the NHDR.

Further information on this and other heart disease measures is available at http://www.cms.hhs.gov/QualityInitiativesGenInfo/.

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Treatment of Acute Heart Failure

Measure Title

Heart failure patients having evaluation of left ventricular ejection fraction.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Table

50 Percent of heart failure patients having evaluation of left ventricular ejection fraction, all payers, United States, 2005

Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

Denominator

Medicare live discharges with a principal diagnosis of heart failure (ICD-9-CM codes 402.01, 402.11, 402.91, 404.01, 404.11, 404.13, 404.91, 404.93, 428.0, 428.1, 428.20-428.23, 428.30-428.33, 428.40-428.43, 428.9).

Numerator

Heart failure patients with documentation in the hospital record that left ventricular ejection fraction was assessed before arrival, during hospitalization, or is planned for after discharge.

Comments

Excludes patients less than age 18; patients transferred to another acute care hospital; patients who expired; and patients who left against medical advice; patients discharged to hospice; patients with reasons documented by a physician, nurse practitioner, or physician assistant for no LVF assessment.

This measure is also a Joint Commission on Accreditation of Healthcare Organizations core measure.

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Treatment of Acute Heart Failure

Measure Title

Heart failure patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Table

51 Percent of heart failure patients with left ventricular systolic dysfunction prescribed ACE inhibitor or angiotensin receptor blocker at discharge, all payers, United States, 2005

Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

Denominator

Medicare live discharges age 18 and over meeting both of the following criteria: (1) principal diagnosis of heart failure (ICD-9-CM codes 402.01, 402.11, 402.91, 404.01, 404.11, 404.91, 428.x); (2) documented left ventricular function evaluation not consistent with left ventricular systolic dysfunction (ejection fraction less than 40% or equivalent narrative description).

Numerator

Subset of the denominator who meet at least one of the following three conditions: (1) on ACE inhibitor at discharge; (2) chart documentation of one or more of the following contraindications to ACE inhibitor use: moderate or severe aortic stenosis; or bilateral renal artery stenosis; or history of angioedema, hives, or severe rash with ACEI use; (3) physician documentation of any specific reason why ACE inhibitor is not used.

Comments

The measure specifications exclude patients transferred to another acute care hospital, patients who expired, patients who left against medical advice, patients on dialysis, patients on angiotensin receptor blocker (ARB) but not ACE inhibitor at discharge, and patients participating in a clinical trial testing alternatives to ACE inhibitors as first-line heart failure therapy.

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Management of Congestive Heart Failure

Measure Title

Hospital admissions for congestive heart failure per 100,000 population.

Measure Source

Healthy People 2010.

Table

52 Hospitalizations for congestive heart failure per 1,000 population, United States, 2005, by

  • Race.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Hospital Discharge Survey (NHDS).

Denominator

U.S. civilian population.

Numerator

Number of discharges with a principal diagnosis of congestive heart failure (ICD-9-CM code 428.0).

Comments

This measure is referred to as measure 12-6 in Healthy People 2010 documentation.

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Inpatient Mortality for Cardiovascular Conditions and Procedures

Measure Title

Deaths per 1,000 adult admissions with acute myocardial infarction.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Inpatient Quality Indicators (IQI).

Table

53 Deaths per 1,000 admissions with acute myocardial infarction (AMI) as principal diagnosis (excluding transfers to another hospital), age 18 and over, United States, 2004, by

  • Race/ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP).

Denominator

All hospital inpatient discharges age 18 and older with a principal diagnosis code of AMI (ICD-9-CM 410.01, 410.51, 410.11, 410.61, 410.21, 410.71, 410.31, 410.81, 410.41, 410.91). Excludes patients transferring to another short-term hospital and obstetric and neonatal admissions.

Numerator

Number of deaths with a principal diagnosis code of AMI.

Comments

Rates are adjusted by age, gender, age-gender interactions, and APR-DRG risk of mortality score. When reporting is by age, the adjustment is by gender and APR-DRG risk of mortality score; when reporting is by gender, the adjustment is by age and APR-DRG risk of mortality score.

The disparities analysis file, created specifically for this report to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 23 States that participate in HCUP and have high-quality race/ethnicity data: AZ, AR, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, RI, SC, TN, TX, VA, VT, and WI.

This table was created using version 2.1, revision 3, of the AHRQ Inpatient Quality Indicators software. This measure is referred to as indicator 15 in the AHRQ Inpatient Quality Indicators software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

This measure and its tables are also presented in other relevant sections of the report.

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Inpatient Mortality for Cardiovascular Conditions and Procedures

Measure Title

Deaths per 1,000 adult admissions with congestive heart failure.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Inpatient Quality Indicators (IQI).

Table

54 Deaths per 1,000 admissions with congestive heart failure (CHF) as principal diagnosis (excluding obstetric and neonatal admissions and transfers to another hospital), age 18 and over, United States, 2004, by

  • Race/ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP).

Denominator

All discharges with principal diagnosis code of CHF, age 18 and older. More information about the AHRQ Quality Indicators, including the specific ICD-9-CM codes used to define CHF, is available at http://www.qualityindicators.ahrq.gov. Excludes patients transferring to another short-term hospital, obstetric and neonatal admissions.

Numerator

Number of deaths with a principal diagnosis code of CHF.

Comments

Rates are adjusted by age, gender, age-gender interactions, and APR-DRG risk of mortality score. When reporting is by age, the adjustment is by gender and APR-DRG risk of mortality score; when reporting is by gender, the adjustment is by age and APR-DRG risk of mortality score.

The disparities analysis file, created specifically for this report to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 23 States that participate in HCUP and have high-quality race/ethnicity data: AZ, AR, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, RI, SC, TN, TX, VA, VT, and WI.

This table was created using version 2.1, revision 3, of the AHRQ Inpatient Quality Indicators software. This measure is referred to as indicator 16 in the AHRQ Inpatient Quality Indicators software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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Inpatient Mortality for Cardiovascular Conditions and Procedures

Measure Title

Deaths per 1,000 adult admissions with coronary artery bypass surgery, age 40 and over.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Inpatient Quality Indicators (IQI).

Table

55 Deaths per 1,000 admissions with coronary artery bypass graft (CABG) (excluding obstetric and neonatal admissions and transfers to another hospital), age 40 and over, United States, 2004, by

  • Race/ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP).

Denominator

Hospital inpatient discharges age 40 and older with a coronary artery bypass graft (ICD-9-CM codes 36.10 through 36.19) in any procedure field. Excludes patients transferring to another short-term hospital and obstetric and neonatal admissions.

Numerator

Number of deaths with a code of CABG in any procedure field.

Comments

Rates are adjusted by age, gender, age-gender interactions, and APR-DRG risk of mortality score. When reporting is by age, the adjustment is by gender and APR-DRG risk of mortality score; when reporting is by gender, the adjustment is by age and APR-DRG risk of mortality score.

The disparities analysis file, created specifically for this report to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 23 States that participate in HCUP and have high-quality race/ethnicity data: AZ, AR, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, RI, SC, TN, TX, VA, VT, and WI.

This table was created using version 2.1, revision 3, of the AHRQ Inpatient Quality Indicators software. This measure is referred to as indicator 12 in the AHRQ Inpatient Quality Indicators software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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Inpatient Mortality for Cardiovascular Conditions and Procedures

Measure Title

Deaths per 1,000 adult admissions with percutaneous transluminal coronary angioplasty, age 40 and over.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Inpatient Quality Indicators (IQI).

Table

56 Deaths per 1,000 adult admissions age 40 and over with percutaneous transluminal coronary angioplasties (PTCA) (excluding obstetric and neonatal admissions and transfers to another hospital), United States, 2004, by

  • Race/ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP).

Denominator

Hospital inpatient discharges age 40 and over with percutaneous transluminal coronary angioplasties (ICD-9-CM codes 36.01, 36.02, 36.05, or 36.06) in any procedure field, excluding obstetric and neonatal admissions and transfers to another hospital.

Numerator

Number of deaths with a code of PTCA in any procedure field.

Comments

Rates are adjusted by age, gender, age-gender interactions, and APR-DRG risk of mortality score. When reporting is by age, the adjustment is by gender and APR-DRG risk of mortality score; when reporting is by gender, the adjustment is by age and APR-DRG risk of mortality score.

The disparities analysis file, created specifically for this report to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 23 States that participate in HCUP and have high-quality race/ethnicity data: AZ, AR, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, RI, SC, TN, TX, VA, VT, and WI.

This table was created using version 2.1, revision 3, of the AHRQ Inpatient Quality Indicators software. This measure is referred to as indicator 30 in the AHRQ Inpatient Quality Indicators software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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Inpatient Mortality for Cardiovascular Conditions and Procedures

Measure Title

Deaths per 1,000 admissions with abdominal aortic aneurysm repair.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Inpatient Quality Indicators (IQI).

Table

57 Deaths per 1,000 admissions with abdominal aortic aneurysm (AAA) repair (excluding obstetric and neonatal admissions and transfers to another hospital), age 18 and over, United States, 2004, by

  • Race/ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP).

Denominator

Hospital inpatient discharges with an AAA repair procedure (ICD-9-CM codes of 38.34, 38.44, and 38.64) in any procedure field and a diagnosis code of AAA (ICD-9-CM 44.13, 44.14) in any field, excluding patients transferring to another short-term hospital and obstetric and neonatal admissions.

Numerator

Number of deaths with an AAA repair surgery in any procedure field.

Comments

Rates are adjusted by age, gender, age-gender interactions, and APR-DRG risk of mortality score. When reporting is by age, the adjustment is by gender and APR-DRG risk of mortality score; when reporting is by gender, the adjustment is by age and APR-DRG risk of mortality score.

The disparities analysis file, created specifically for this report to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 23 States that participate in HCUP and have high-quality race/ethnicity data: AZ, AR, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, RI, SC, TN, TX, VA, VT, and WI.

This table was created using version 2.1, revision 3, of the AHRQ Inpatient Quality Indicators software. This measure is referred to as indicator 11 in the AHRQ Inpatient Quality Indicators software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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Inpatient Mortality for Cardiovascular Conditions and Procedures

Measure Title

Deaths per 1,000 pediatric heart surgery admissions, under age 18.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Inpatient Quality Indicators (IQI).

Table

58 Deaths per 1,000 pediatric heart surgery admissions, patients under age 18 (excluding obstetric admissions; patients with transcatheter interventions as single cardiac procedures, performed without bypass but with catheterization; patients with septal defects as single cardiac procedures without bypass; heart transplant; premature infants with patent ductus arteriosus (PDA) closure as only cardiac procedure; and age less than 30 days with PDA closure as only cardiac procedure; and transfers to another hospital), United States, 2003, by

  • Race/Ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP).

Denominator

Hospital inpatient discharges with a procedure for (1) specified heart surgery in any field or (2) any heart surgery and diagnosis of hypoplastic left heart syndrome in any field. Age less than 18 years. Excludes patients transferring to another short-term hospital; obstetric admission; patients who underwent patent ductus arteriosus (PDA) ligation as a single cardiac procedure; patients with prosthetic closures of atrial septal defects or ventricular septal defects or atrial septal enlargement without concomitant use of cardiopulmonary bypass; patients with PDA closure as a single cardiac procedure with concomitant cardiac catheterization; patients with occlusion of thoracic vessel without congenital heart defect. More information about the AHRQ Quality Indicators, including the specific ICD-9-CM codes used to define this Inpatient Quality Indicator, is available at http://www.qualityindicators.ahrq.gov.

Numerator

Number of deaths with a code of pediatric heart surgery in any procedure field.

Comments

Rates are adjusted by age, gender, age-gender interactions, and APR-DRG risk of mortality score. When reporting is by age, the adjustment is by gender and APR-DRG risk of mortality score; when reporting is by gender, the adjustment is by age and APR-DRG risk of mortality score.

The disparities analysis file, created specifically for this report to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 23 States that participate in HCUP and have high-quality race/ethnicity data: AZ, AR, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, RI, SC, TN, TX, VA, VT, and WI.

This table was created using version 2.1, revision 3, of the AHRQ Inpatient Quality Indicators software. This measure is referred to as indicator 10 in the AHRQ Inpatient Quality Indicators software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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Management of Hypertension

Measure Title

Percent of people with hypertension who have blood pressure under control.

Measure Source

Healthy People 2010.

Table

59 Percent of adults age 18 and over with hypertension whose blood pressure is under control, United States, 1999-2004

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health and Nutrition Examination Survey (NHANES).

Denominator

U.S. civilian noninstitutionalized adults age 18 and over either having elevated blood pressure (average systolic pressure of at least 140 mm Hg or average diastolic pressure of at least 90 mm Hg) or taking antihypertension medication.

Numerator

Subset of denominator with average systolic blood pressure less than 140 mm Hg and average diastolic blood pressure less than 90 mm Hg based on average of three measurements and taking antihypertension medication.

Comments

Rates are age adjusted using the 2000 standard population.

This measure is referred to as measure 12-10 in Healthy People 2010 documentation.

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Preventive Care

Measure Title

Noninstitutionalized adults who were obese who were told by a doctor they were overweight.

Measure Source

Healthy People 2010.

Table

60 Percent of obese adults age 20 and over who had been told by a doctor or health professional that they were overweight, United States, 1999-2004

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health and Nutrition Examination Survey (NHANES).

Denominator

Persons age 20 and over with a body mass index (BMI) of 30 or greater.

Numerator

Subset of denominator who reported they were told by a doctor or health professional that they were overweight.

Comments

This measure is referred to as measure 19-2 in Healthy People 2010 documentation.

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Preventive Care

Measure Title

Noninstitutionalized adults who were obese who were given advice about exercise.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

61 Adults who were obese who were given advice about exercise, United States, 2004, by

  • Race.
  • Ethnicity.
  • Family income.
  • Education.

Data Source

AHRQ, CFACT, MEPS.

Denominator

Persons age 18 and over with a body mass index (BMI) of 30 or greater.

Numerator

Subset of denominator who reported they were given advice about exercise by a doctor or health professional.

Comments

Nonresponses and "Don't know" responses were excluded from the analysis.

This measure and its tables are also presented in other relevant sections of the report.

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Preventive Care

Measure Title

Noninstitutionalized adults who were obese who were given advice about eating fewer high fat or high cholesterol foods.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

62 Adults who were obese who were given advice about eating fewer high fat or high cholesterol foods, United States, 2004, by

  • Race.
  • Ethnicity.
  • Family income.
  • Education.

Data Source

AHRQ, CFACT, MEPS.

Denominator

Persons age 18 and over with a body mass index (BMI) of 30 or greater.

Numerator

Subset of denominator who reported they were advised by a doctor or health professional about restricting foods high in fat and cholesterol.

Comments

Nonresponses and "Don't know" responses were excluded from the analysis.


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