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2006 National Healthcare Quality Report

Effectiveness of Care: Maternal and Child Health

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Maternity Care
Pregnant women receiving prenatal care in the first trimester
Liveborn infants with low and very low birthweight
Infant mortality per 1,000 live births
Maternal deaths per 100,000 live births
Immunization, Childhood
Children 19-35 months who received all recommended vaccines
Immunization, Adolescent
Adolescents (13-15) reported to have received 3 or more doses of hepatitis B vaccine
Adolescents (13-15) reported to have received 2 or more doses of MMR vaccine
Adolescents (13-15) reported to have received 1 or more doses of tetanus-diphtheria booster
Adolescents (13-15) reported to have received 1 or more doses of varicella vaccine
Childhood Dental Care
Children 2-17 who report having a dental visit in the last year
Treatment of Pediatric Gastroenteritis
Hospital admissions for pediatric gastroenteritis per 100,000 population under 18
Childhood Preventive Care
Children under 18 who had their height and weight measured by a doctor or other health provider
Children 2-17 for whom a doctor or other health provider gave advice about amount and kind of physical activity
Children 2-17 for whom a doctor or other health provider gave advice about eating healthy
Children 3-6 whose vision was checked by a doctor or other health provider
Children under 18 for whom a doctor or other health provider gave advice about how smoking in the house can be harmful
Children under 18 for whom a doctor or other health provider gave advice about using car safety restraints
Children 2-17 for whom a doctor or other health provider gave advice about using a helmet when riding a bicycle or motorcycle
Children who were overweight who were told by a doctor they were overweight


Maternity Care

Measure Title

Percent of pregnant women receiving prenatal care in the first trimester.

Measure Source

Healthy People 2010, measure 16-6a.

Tables

1.65a. Percent of pregnant women receiving prenatal care in the first trimester, United States, 1998 and 2003.

1.65b. Percent of pregnant women receiving prenatal care in the first trimester, by State, 1998 and 2003.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Vital Statistics System—Natality.

Denominator

Number of live births.

Numerator

Mothers of liveborn infants receiving prenatal care in the first trimester (3 months) of pregnancy.

Comments

A description of the primary measurement used to determine the fetus' gestational age (the interval between the first day of the last normal menstrual period and the birth) has been published by the NCHS. See http://www.cdc.gov/nchs for more information about linked birth and infant death data.

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Maternity Care

Measure Title

Percent of liveborn infants with low and very low birthweight (less than 2,500 grams, less than 1,500 grams).

Measure Source

Healthy People 2010, measure 16-10.

Tables

1.66a. Percent of liveborn infants with low birthweight (less than 2,500 grams), United States, 1998 and 2003.

1.66b. Percent of liveborn infants with very low birthweight (less than 1,500 grams), United States, 1998 and 2003.

1.66c. Percent of liveborn infants with low birthweight (less than 2,500 grams), by State, 1998 and 2003.

1.66d Percent of liveborn infants with very low birthweight (less than 1,500 grams), by State, 1998 and 2003.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Vital Statistics System—Natality.

Denominator

Number of live births.

Numerator

Number of live births with birthweight of less than 2,500 grams (5 lbs. 8 oz) or less than 1,500 grams (3 lbs. 3 oz).

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Maternity Care

Measure Title

Infant mortality per 1,000 live births.

Measure Source

Healthy People 2010, measure 16-1c.

Tables

1.67a. Infant mortality per 1,000 live births, United States, 1998 and 2003.

1.67b. Infant mortality per 1,000 live births, birthweight <1,500 grams, United States, 2002 and 2003.

1.67c. Infant mortality per 1,000 live births, birthweight 1,500-2,499 grams, United States, 2002 and 2003.

1.67d. Infant mortality per 1,000 live births, birthweight > 2,499 grams, United States, 2002 and 2003.

1.67e. Infant mortality per 1,000 live births, by State, 1998 and 2003.

1.67f. Infant mortality per 1,000 live births, birthweight < 1,500 grams, by State, 2002 and 2003.

1.67g. Infant mortality per 1,000 live births, birthweight 1,500-2,499 grams, by State, 2002 and 2003.

1.67h. Infant mortality per 1,000 live births, birthweight > 2,499 grams, by State, 2002 and 2003.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Vital Statistics System—Linked Birth and Infant Death Data.

Denominator

Resident live births.

Numerator

Number of infant deaths within the first year.

Comments

In the Linked Birth and Infant Death file, the information from the death certificate is linked to information on the birth certificate for each infant under 1 year who died during the calendar year.

The number of deaths for infant mortality is based on a record weight from the linked birth and infant death file which adjusts for the approximately 2-3% of records each year which cannot be linked to their corresponding birth certificates.

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Maternity Care

Measure Title

Maternal deaths per 100,000 live births.

Measure Source

Healthy People 2010, measure 16-4.

Tables

1.68a. Maternal deaths per 100,000 live births, United States, 1999 and 2003.

1.68b. Maternal deaths per 100,000 live births, by State, 1999 and 2003.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Vital Statistics System—Mortality.

Denominator

Resident live births.

Numerator

Number of female deaths due to obstetric causes (ICD-10-CM codes O00-O95, O98-O99) within 42 days of a pregnancy.

Comments

Caution should be used when comparing these data with pregnancy-related mortality rates from other reports. NCHS uses the definition of maternal mortality and related coding conventions recommended in the ICD-9-CM by the World Health Organization. Other definitions may use different time intervals from pregnancy to death and may be more inclusive with regard to cause of death.

A description of the maternal mortality measurement has been published by NCHS. See http://www.cdc.gov/nchs for more information about linked birth and infant death data.

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Immunization, Childhood

Measure Title

Percent of children 19-35 months who received all recommended vaccines.

Measure Source

Healthy People 2010, measure 14-24a.

Tables

1.69a. Percent of children age 19-35 months who received all recommended vaccines (4:3:1:3:3), United States, 1998 and 2004.

1.69b. Percent of children age 19-35 months who received all recommended vaccines (4:3:1:3:3), by State, 2000 and 2004.

Data Source

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

Denominator

U.S. civilian noninstitutionalized population: children, age 19-35 months.

Numerator

Number of children, age 19-35 months, receiving at least 4 doses of diphtheria-tetanus-acellular pertussis (DTaP), at least 3 doses of polio, at least 1 dose of measles-mumps-rubella (MMR), at least 3 doses of Haemophilus influenza B (Hib), and at least 3 doses of hepatitis B antigens.

Comments

Race categories changed in 2001. Data for 2001 and later years may not be comparable to data from previous years.

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Immunization, Adolescent

Measure Title

Percent of adolescents (age 13-15) reported to have received 3 or more doses of hepatitis B vaccine.

Measure Source

Healthy People 2010, measure 14-27a.

Table

1.70. Percent of adolescents age 13-15 who received 3 or more doses of hepatitis B vaccine, United States, 1999 and 2003.

Data Source

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

Denominator

U.S. civilian noninstitutionalized population: number of adolescents, age 13-15.

Numerator

Number of adolescents, age 13-15, reported to be vaccinated with 3 or more doses of the hepatitis B antigens.

Comments

Race categories changed in 2001. Data for 2001 and later years may not be comparable to data from previous years.

Percents are not age adjusted.

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Immunization, Adolescent

Measure Title

Percent of adolescents (age 13-15) reported to have received 2 or more doses of MMR vaccine.

Measure Source

Healthy People 2010, measure 14-27b.

Table

1.71. Percent of adolescents age 13-15 who received 2 or more doses of measles-mumps-rubella vaccine, United States, 1999 and 2003.

Data Source

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

Denominator

U.S. civilian noninstitutionalized population: number of adolescents, age 13-15.

Numerator

Number of adolescents, age 13-15, reported to be vaccinated with 2 or more doses of measles-mumps-rubella (MMR) vaccine.

Comments

Race categories changed in 2001. Data for 2001 and later years may not be comparable to data from previous years.

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Immunization, Adolescent

Measure Title

Percent of adolescents (age 13-15) reported to have received 1 or more doses of tetanus-diphtheria booster.

Measure Source

Healthy People 2010, measure 14-27c.

Table

1.72. Percent of adolescents age 13-15 who received 1 or more doses of tetanus-diphtheria booster, United States, 1999 and 2003.

Data Source

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

Denominator

U.S. civilian noninstitutionalized population: number of adolescents, age 13-15.

Numerator

Number of adolescents, age 13-15, reported to be vaccinated with 1 or more doses of the tetanus and diphtheria antigens.

Comments

Race categories have changed since 2001. Data for 2001 and later years may not be comparable to data from previous years.

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Immunization, Adolescent

Measure Title

Percent of adolescents (age 13-15) reported to have received 1 or more doses of varicella vaccine.

Measure Source

Healthy People 2010, measure 14-27d.

Table

1.73. Percent of adolescents age 13-15 who received 1 or more doses of varicella vaccine, United States, 1999 and 2003.

Data Source

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

Denominator

U.S. civilian noninstitutionalized population: number of adolescents, age 13-15, excluding those who are reported to ever have had varicella (chicken pox).

Numerator

Number of adolescents, age 13-15, reported to be vaccinated with 1 or more doses of the varicella antigen.

Comments

Race categories changed since 2001. Data for 2001 and later years may not be comparable to data from previous years.

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Childhood Dental Care

Measure Title

Percent of children age 2-17 who report having a dental visit in the last year.

Measure Source

Healthy People 2010, measure 21-10.

Table

1.74. Percent of children age 2-17 with a dental visit in the past year, United States, 2000 and 2003.

Data Source

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

Denominator

U.S. population, children age 2-17.

Numerator

Number of children, age 2-17, who had a dental visit in the survey year.

Comments

The age used to subset child population for the "children with special health care needs (CSHCN)" category is the age at the interview rounds when the questions about whether the child needs special health care were asked. For other categories, it is the age at the end of the year.

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Treatment of Pediatric Gastroenteritis

Measure Title

Hospital admissions for pediatric gastroenteritis per 100,000 population under age 18.

Measure Source

Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators.

Tables

1.75a. Admissions for pediatric gastroenteritis (excluding obstetric and neonatal admissions and transfers from other institutions) per 100,000 population, age less than 18 years, United States, 2001 and 2003.

1.75b Admissions for pediatric gastroenteritis (excluding obstetric and neonatal admissions and transfers from other institutions) per 100,000 population, age less than 18 years, by State, 2002 and 2003.

Data Source

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

Denominator

U.S. population under age 18.

Numerator

Pediatric discharges under age 18 with a principal diagnosis for gastroenteritis (ICD-9-CM codes 008.61-008.67, 008.69, 008.8, 009.0-009.3, and 558.9), excluding obstetric and neonatal admissions and transfers from other institutions.

Comments

Rates in the national table are adjusted by age and gender using the total U.S. population for 2000 as the standard population. When reporting is by age, the adjustment is by gender only; when reporting is by gender, the adjustment is by age only.

Rates in the State table are adjusted by age and gender, using the total U.S. population for 2000 as the standard population

Although not all States participate in the HCUP database, the Nationwide Inpatient Sample is weighted to give national estimates using weights based on all U.S. community, non-rehabilitation hospitals in the American Hospital Association Annual Survey of Hospitals.

These tables were created using version 2.1, revision 3, of the AHRQ Prevention Quality Indicators software. This measure is referred to as indicator 6 in the software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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Childhood Preventive Care

Measure Title

Percent of children under age 18 who had their height and weight measured by a doctor or other health provider.

Measure Source

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

Tables

1.76a. Percent of children under age 18 who had their height and weight measured by a doctor or other health provider, United States, 2003.

1.76b. Percent of children under age 18 who had their height and weight measured by a doctor or other health provider, United States, 2001.

Data Source

AHRQ, MEPS.

Denominator

Children under age 18 for the "Ever given advice" estimates, excluding nonrespondents to the questions of whether height or weight was measured by a doctor or other healthcare provider. "Don't know" responses to the questions of when the weight and/or height was measured were further excluded from the "within the past year" and "within the past 2 years" estimates.

Numerator

Children under age 18 who ever had both height and weight measured for the "Ever had both measures" estimates. Children who had both measurements within the past year for the "Within the past year" estimates. Children who had both measurements, either within the past year or 2 years for the "Within the past 2 years" estimates.

Comments

This measure combined weight and height measurements. The denominator and numerator were further modified regarding missing values and the combination.

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Childhood Preventive Care

Measure Title

Percent of children age 2-17 for whom a doctor or other health provider gave advice about amount and kind of physical activity.

Measure Source

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

Tables

1.77a. Percent of children age 2-17 for whom a doctor or other health provider gave advice about amount and kind of physical activity, United States, 2003.

1.77b. Percent of children age 2-17 for whom a doctor or other health provider gave advice about amount and kind of physical activity, United States, 2001.

Data Source

AHRQ, MEPS.

Denominator

Children age 2-17 for the "Ever given advice" estimates, excluding nonrespondents to the question, "Has a doctor or other health provider ever given advice about amount and kind of exercise, sports, or physically active hobbies you should have?" "Don't know" responses to the question of when the advice was given were further excluded from the "within the past year" and "within the past 2 years" estimates.

Numerator

Children age 2-17 for whom a doctor or other health provider had ever given advice about amount and kind of physical activity for the "Ever given advice" estimates. Children who were given the advice within the past year for "Within the past year" estimates. Children who were given the advice within the past year or 2 years for "Within the past 2 years" estimates.

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Childhood Preventive Care

Measure Title

Percent of children age 2-17 for whom a doctor or other health provider gave advice about eating healthy.

Measure Source

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

Tables

1.78a. Percent of children age 2-17 for whom a doctor or other health provider gave advice about eating healthy, United States, 2003.

1.78b. Percent of children age 2-17 for whom a doctor or other health provider gave advice about eating healthy, United States, 2001.

Data Source

AHRQ, MEPS.

Denominator

Children age 2-17 for the "Ever given advice" estimates, excluding nonrespondents to the question, "Has a doctor or other health provider ever given advice about eating healthy?" "Don't know" responses to the question of when the advice was given were further excluded for the "within the past year" and "within the past 2 years" estimates.

Numerator

Children age 2-17 for whom a doctor or other health provider had ever given advice about eating healthy for the "Ever given advice" estimates. Children who were given the advice within the past year for "Within the past year" estimates. Children who were given the advice within the past year or 2 years for "Within the past 2 years" estimates.

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Childhood Preventive Care

Measure Title

Percent of children age 3-6 whose vision was checked by a doctor or other health provider.

Measure Source

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

Table

1.79. Percent of children age 3-6 whose vision was checked by a doctor or other health provider, United States, 2001 and 2003.

Data Source

AHRQ, MEPS.

Denominator

Children age 3-6. Nonresponses, as well as "Don't know" responses, were excluded.

Numerator

Children age 3-6 whose vision had ever been checked by a doctor or other health provider.

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Childhood Preventive Care

Measure Title

Percent of children under age 18 for whom a doctor or other health provider gave advice about how smoking in the house can be harmful.

Measure Source

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

Tables

1.80a. Percent of children under age 18 for whom a doctor or other health provider gave advice about how smoking in the house can be harmful, United States, 2003.

1.80b. Percent of children under age 18 for whom a doctor or other health provider gave advice about how smoking in the house can be harmful, United States, 2001.

Data Source

AHRQ, MEPS.

Denominator

Children under age 18 for the "Ever given advice" estimates, excluding nonrespondents to the question of whether a doctor or other health provider had ever given advice about how smoking in the house can be harmful. "Don't know" responses to the question of when the advice was given were further excluded for the "within the past year" and "within the past 2 years" estimates.

Numerator

For the "Ever given advice" estimates, children under age 18 for whom a doctor or other health provider had ever given advice about how smoking in the house can be harmful. Children who were given the advice within the past year for "Within the past year" estimates. Children who were given the advice within the past year or 2 years for "Within the past 2 years" estimates.

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Childhood Preventive Care

Measure Title

Percent of children under age 18 for whom a doctor or other health provider gave advice about using car safety restraints.

Measure Source

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

Tables

1.81a. Percent of children under age 18 for whom a doctor or other health provider gave advice about using car safety restraints, United States, 2003.

1.81b. Percent of children under age 18 for whom a doctor or other health provider gave advice about using car safety restraints, United States, 2001.

Data Source

AHRQ, MEPS.

Denominator

Children under age 18 for the "Ever given advice" estimates, excluding nonrespondents to the question of whether a doctor or other health provider had ever given advice about using car safety restraints. "Don't know" responses to the question of when the advice was given were further excluded for the "within the past year" and "within the past 2 years" estimates.

Numerator

For the "Ever given advice" estimates, children under age 18 for whom a doctor or other health provider had ever given advice about using a child car safety seat, a booster seat or lap and shoulder belts Children who were given the advice within the past year for "Within the past year" estimates. Children who were given the advice within the past year or 2 years for "Within the past 2 years" estimates.

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Childhood Preventive Care

Measure Title

Percent of children age 2-17 for whom a doctor or other health provider gave advice about using a helmet when riding a bicycle or motorcycle.

Measure Source

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

Tables

1.82a. Percent of children age 2-17 for whom a doctor or other health provider gave advice about using a helmet when riding a bicycle or motorcycle, United States, 2003.

1.82b. Percent of children age 2-17 for whom a doctor or other health provider gave advice about using a helmet when riding a bicycle or motorcycle, United States, 2001.

Data Source

AHRQ, MEPS.

Denominator

Children under age 18 for the "Ever given advice" estimates, excluding nonrespondents to the question of whether a doctor or other health provider had ever given advice about using a helmet when riding a bicycle or motorcycle. "Don't know" responses to the question of when the advice was given were further excluded for the "within the past year" and "within the past 2 years" estimates.

Numerator

For the "Ever given advice" estimates, children age 2-17 for whom a doctor or other health provider had ever given advice about using a helmet when riding a bicycle or motorcycle. Children who were given the advice within the past year for "Within the past year" estimates. Children who were given the advice within the past year or 2 years for "Within the past 2 years" estimates.

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Childhood Preventive Care

Measure Title

Non-institutionalized children who were overweight who were told by a doctor they were overweight.

Measure Source

Healthy People 2010, measure 19-3c.

Table

1.83. Percent of overweight children and teens age 2-19 who had been told by a doctor or health professional that they were overweight, United States, 1999-2002.

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 2-19 and over with a body mass index (BMI) greater than or equal to the 95th percentile on the BMI-for-age, sex-specific 2000 CDC growth charts for the United States.

Numerator

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

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