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2006 National Healthcare Quality Report

Timeliness

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Basic Access
Persons who report that they have a usual source of medical care, by place of care
Families who experienced difficulty in obtaining care, by reason
Getting Appointments for Care
Among adults 18+ who reported making an appointment for routine health care in the last 12 months, how often they got an appointment as soon as wanted
Among children under 18 who had appointments reported for routine health care in the last 12 months, how often they got an appointment as soon as wanted
Among adults 18+ who reported making an appointment for an illness or injury in the last 12 months, how often they got an appointment for illness or injury as soon as they wanted
Among children under 18 who had appointments reported for an illness or injury in the last 12 months, how often they got an appointment for illness or injury as soon as they wanted
Waiting Time
Percent of emergency department (ED) visits where patient was admitted to the hospital or transferred to other facility whose ED visit was greater than or equal to 6 hours
Percent of emergency department (ED) visits where patients left before being seen


Basic Access

Measure Title

Percent of persons who report that they have a usual source of medical care, by place of care.

Measure Source

Healthy People 2010, measure 1-4.

Tables

3.1a. Percent of persons who had a specific source of ongoing care, United States, 1999 and 2004.

3.1b. Percent of persons with a hospital, emergency room, or clinic as a source of ongoing care, United States, 1999 and 2004.

3.1c. Percent of persons in fair or poor health who had a specific source of ongoing care, United States, 1999 and 2004.

Data Source

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

Denominator

Table 3.1a and 3.1b: U.S. population.

Table 3.1c: Persons with fair or poor health status.

Numerator

Table 3.1a: Number of persons who report having a usual source of primary care.

Table 3.1b: Number of persons who report that their usual source of medical care is a hospital or outpatient clinic or emergency room.

Table 3.1c: Number of persons with fair to poor health status who report that they have a usual source of medical care.

Comments

A specific source of primary care includes urgent care/walk-in clinic, doctor's office, clinic, health center facility, hospital outpatient clinic, HMO/PPO, military or other Veterans Administration health care, or some other place. A hospital emergency room is not included as a specific source of primary care.

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

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Basic Access

Measure Title

Percent of families who experienced difficulty in obtaining care, by reason.

Measure Source

Healthy People 2010, measure 1-6.

Tables

3.2A_a. Percent of families unable to receive or delayed in receiving needed medical care, dental care, or prescription medications, by main reasons, United States, 2003.

3.2A_b. Percent of families unable to receive or delayed in receiving needed medical care, by main reasons, United States, 2003.

3.2A_c. Percent of families unable to receive or delayed in receiving needed dental care, by main reasons, United States, 2003.

3.2A_d. Percent of families unable to receive or delayed in receiving needed prescription medications, by main reasons, United States, 2003.

3.2B_a. Percent of families unable to receive or delayed in receiving needed medical care, dental care, or prescription medications, by main reasons, United States, 2002.

3.2B_b. Percent of families unable to receive or delayed in receiving needed medical care, by main reasons, United States, 2002.

3.2B_c. Percent of families unable to receive or delayed in receiving needed dental care, by main reasons, United States, 2002.

3.2B_d. Percent of families unable to receive or delayed in receiving needed prescription medications, by main reasons, United States, 2002.

Data Source

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

Denominator

U.S. families reporting that at least 1 family member experienced difficulty in obtaining health care, including those with members who attempted but did not receive care or delayed the needed care.

Numerator

Subset of the denominator of families with each of the 3 major reasons, couldn't afford, insurance-related reasons and other reasons.

Comments

A change in survey question format in 2002 affected the way responses were collected for this item; these rates should not be compared to data from 2001 and earlier, reported in prior editions of the National Healthcare Quality Report.

Reasons were grouped based on specific survey responses. The demographic data are based on information for the family reference person.

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Getting Appointments for Care

Measure Title

Among adults age 18 and over who reported making an appointment for routine health care in the last 12 months, percent distribution of how often they got an appointment as soon as wanted.

Measure Source

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

National Tables

3.3a. Among adults age 18 and over who reported making an appointment for routine health care in the last 12 months, percent distribution of how often they got an appointment as soon as wanted, United States, 2003.

3.3b. Among adults age 18 and over who reported making an appointment for routine health care in the last 12 months, percent distribution of how often they got an appointment as soon as wanted, United States, 2000.

National Data Source

AHRQ, MEPS.

National Denominator

Adults age 18 and over who made an appointment for regular or routine health care in the past 12 months and answered the question "In the last 12 months, how often did you get an appointment for regular or routine health care as soon as you wanted?" Nonresponses, as well as "Don't know" responses, were excluded.

National Numerator

Subset of the denominator population in 3 categories according to their answer to the above question: "Always," "Usually," "Sometimes," or "Never."

State Tables

3.3c. Among adults age 18 and over who reported making an appointment for routine health care in the last 6 months, percent who reported that they always got an appointment for routine care as soon as they wanted, Medicaid, by State, 2004 and 2005.

3.3d. Among adults age 18 and over who reported making an appointment for routine health care in the last 12 months, percent who reported that they always got an appointment for routine care as soon as they wanted, Medicare fee for service, by State, 2003 and 2004.

3.3e. Among adults age 18 and over who reported making an appointment for routine health care in the last 12 months, percent who reported that they always got an appointment for routine care as soon as they wanted, Medicare managed care, by State, 2003 and 2004.

State Data Source

Agency for Healthcare Research and Quality, Center for Quality Improvement and Patient Safety, National CAHPS Benchmarking Database.

State Denominator

Respondents who answered "Yes" to the question "In the last 6 months (if Medicaid) or 12 months (if Medicare), did you make any appointments with a doctor or other health care provider for regular or routine health care?"

State Numerator

Subset of the denominator population who answered "Always" to the question "In the last 6 months (if Medicaid) or 12 months (if Medicare), not counting times you needed health care right away, how often did you get an appointment for health care as soon as you wanted?"

Comments

National tables report data from the MEPS Self-Administered Questionnaire (SAQ). See the MEPS entry in the Data Sources section of this appendix for more information on the SAQ.

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Getting Appointments for Care

Measure Title

Among children under age 18 who had appointments reported for routine health care in the last 12 months, percent distribution of how often they got an appointment as soon as wanted.

Measure Source

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

National Tables

3.4a. Among children under age 18 who had appointments reported for routine health care in the last 12 months, percent distribution of how often they got an appointment as soon as wanted, United States, 2003.

3.4b. Among children under age 18 who had appointments reported for routine health care in the last 12 months, percent distribution of how often they got an appointment as soon as wanted, United States, 2001.

National Data Source

AHRQ, MEPS.

National Denominator

Children who had an appointment for regular or routine health care in the past 12 months and with a valid answer to the question "In the last 12 months, how often did (the person) get an appointment for regular or routine health care as soon as you wanted?" Nonresponses, as well as "Don't know" responses, were excluded.

National Numerator

Subset of the denominator population in 3 categories according to the answer to the above question: "Always," "Usually," "Sometimes," or "Never."

State Table

3.4c. Among children under age 18 who had appointments reported for routine health care in the last 6 months, percent who always got an appointment for routine care as soon as they wanted, Medicaid, by State, 2004 and 2005.

State Data Source

AHRQ, Center for Quality Improvement and Patient Safety, National CAHPS Benchmarking Database.

State Denominator

Children with Medicaid benefits who had appointments with a doctor or other health care provider for regular or routine health care in the past 6 months.

State Numerator

Subset of the denominator population with an "Always" answer to the question "In the last 6 months, not counting times you needed health care right away, how often did you get an appointment for health care as soon as you wanted?"

Comments

The national table reports data from the MEPS Child Health section. See the MEPS entry in the Data Sources section of this appendix for more information.

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Getting Appointments for Care

Measure Title

Among adults age 18 and over who reported making an appointment for an illness or injury in the last 12 months, percent distribution of how often they got an appointment for illness or injury as soon as they wanted.

Measure Source

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

National Tables

3.5a. Among adults age 18 and over who reported making an appointment for illness or injury in the last 12 months, percent distribution of how often they got an appointment for illness or injury as soon as they wanted, United States, 2003.

3.5b. Among adults age 18 and over who reported making an appointment for illness or injury in the last 12 months, percent distribution of how often they got an appointment illness or injury as soon as they wanted, United States, 2000.

National Data Source

AHRQ, MEPS.

National Denominator

Adults age 18 and over who had an illness or injury that needed care right away from doctor's office, clinic, or emergency room in the past 12 months and also answered the question of "In the last 12 months, when you needed care right away for an illness or injury, how often did you get care as soon as you wanted?" Nonresponses and "Don't know" responses were excluded.

National Numerator

Subset of the denominator population in 3 categories according to their answer to the above question: "Always," "Usually," "Sometimes," or "Never."

State Tables

3.5c. Among adults age 18 and over who reported making an appointment for illness or injury in the last 6 months, percent who reported that they always got care for illness or injury as soon as they wanted, Medicaid, by State, 2004 and 2005.

3.5d. Among adults age 18 and over who reported making an appointment for illness or injury in the last 12 months, percent who reported that they always got care for illness or injury as soon as they wanted, Medicare fee for service, by State, 2003 and 2004.

3.5e. Among adults age 18 and over who reported making an appointment for illness or injury in the last 12 months, percent who reported that they always got care for illness or injury as soon as they wanted, Medicare managed care, by State, 2003 and 2004.

State Data Source

AHRQ, Center for Quality Improvement and Patient Safety, National CAHPS Benchmarking Database.

State Denominator

Adults who reported having illness, injury, or condition that needed care right away in a clinic, emergency room or doctor's office in the past 6 months (if Medicaid) or 12 months (if Medicare).

State Numerator

Subset of the denominator who answered "Always" to the question "In the last 6 months (if Medicaid) or 12 months (if Medicare), when you needed care right away for an illness, injury, or condition, how often did you get care as soon as you wanted?"

Comments

National tables report data from the MEPS Self-Administered Questionnaire (SAQ). See the MEPS entry in the Data Sources section of this appendix for more information on the SAQ.

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Getting Appointments for Care

Measure Title

Among children under age 18 who had appointments reported for an illness or injury in the last 12 months, percent distribution of how often they got an appointment for illness or injury as soon as they wanted.

Measure Source

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

National Tables

3.6a. Among children under age 18 who had appointments reported for an illness or injury in the last 12 months, percent distribution of how often they got an appointment for illness or injury as soon as they wanted, United States, 2003.

3.6b. Among children under age 18 who had appointments reported for an illness or injury in the last 12 months, percent distribution of how often they got an appointment for illness or injury as soon as they wanted, United States, 2001.

National Data Source

AHRQ, MEPS.

National Denominator

Children under age 18 who had an illness or injury that needed care right away from a doctor's office, clinic, or emergency room in the past 12 months, with a valid answer to the question of "In the last 12 months, when (the person) needed care right away for an illness or injury, how often did [person] get care as soon as you wanted?" Nonresponses and "Don't know" responses were excluded.

National Numerator

Subset of the denominator population in 3 categories according to their answer to the above question: "Always," "Usually," "Sometimes," or "Never."

State Table

3.6c Among children under age 18 who had appointments reported for an illness or injury in the last 6 months, percent who always got care for illness or injury as soon as they wanted, Medicaid, by State, 2004 and 2005.

State Data Source

AHRQ, Center for Quality Improvement and Patient Safety, National CAHPS Benchmarking Database.

State Denominator

Children with Medicaid benefits who had an illness, injury, or condition that needed care right away in a clinic, emergency room or doctor's office in the past 6 months.

State Numerator

Subset of the denominator with an answer of "Always" to the question "In the last 6 months, when you needed care right away for an illness, injury, or condition, how often did you get care as soon as you wanted?"

Comments

The national table reports data from the MEPS Child Health section. See the MEPS entry in the Data Sources section of this appendix for more information.

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Waiting Time

Measure Title

Percent of emergency department (ED) visits where patient was admitted to the hospital or transferred to other facility whose ED visit was greater than or equal to 6 hours.

Measure Source

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

Table

3.7. Percent of emergency department visits where patient was admitted to the hospital or transferred to other facility whose emergency department visit was greater than or equal to 6 hours, United States, 2000-2001 and 2003-2004.

Data Source

CDC, NCHS, National Hospital Ambulatory Medical Care Survey (NHAMCS).

Denominator

Visits to the emergency departments (ED) and later admitted to the hospital or ICU/CCU, or transferred to other facility.

Numerator

Subset of the denominator with those who stayed in emergent/urgent care for 6 hours or more.

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Waiting Time

Measure Title

Percent of emergency department (ED) visits where patients left before being seen.

Measure Source

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

Table

3.8. Emergency department visits in which the patient left without being seen, United States, 1997-1998 and 2003-2004.

Data Source

CDC, NCHS, National Hospital Ambulatory Medical Care Survey (NHAMCS).

Denominator

Visits to the Emergency Departments (ED) and outpatient departments of noninstitutional general and short-stay hospitals, exclusive of Federal, military, and Veterans Administration hospitals located in the 50 States and the District of Columbia.

Numerator

Subset of the denominator with a visit disposition of "left before being seen" on the NHAMCS Emergency Department Patient Record Form.

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