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National Healthcare Quality Report, 2007

Effectiveness of Care: Maternal and Child Health

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Maternity Care
Pregnant women receiving prenatal care in first trimester
Liveborn infants with low (less than 2,500 grams) and very low (less than 1,500 grams) 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
Treatment of Pediatric Gastroenteritis
Hospital admissions for pediatric gastroenteritis per 100,000 population under 18 years of age
Childhood Preventive Care
Children under age 18 who had their height and weight measured by a doctor or other health provider
Children ages 2-17 for whom a doctor or other health provider gave advice about amount and kind of physical activity
Children ages 2-17 for whom a doctor or other health provider gave advice about healthy eating
Children ages 3-6 whose vision was checked by a doctor or other health provider
Children ages 2-17 with a dental visit in the last year
Children with untreated dental caries
Children under age 18 for whom a doctor or other health provider gave advice about how smoking in the house can be harmful
Children under age 18 for whom a doctor or other health provider gave advice about using car safety restraints
Children age 2-17 for whom a doctor or other health provider gave advice about using a helmet when riding a bicycle or motorcycle
Overweight children and teens ages 2-19 who were told by a doctor or health professional they were overweight

Maternity Care

Measure Title

Pregnant women receiving prenatal care in first trimester.

Measure Source

Healthy People 2010.

National Tables

1.72a Pregnant women receiving prenatal care in the first trimester, United States, 1998 and 2004.

National Data Source

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

National Denominator

Number of live births.

National Numerator

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

State Tables

1.72b Percent of pregnant women receiving prenatal care in the first trimester, by State, 1998 and 2004.

State Data Source

CDC, NCHS, NVSS-N.

State Denominator

Population by State.

State Numerator

Same as national.

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 NCHS. See http://www.cdc.gov/nchs/ for more information about linked birth and infant death data.

This measure is referred to as measure 16-6a in Healthy People 2010 documentation.

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Maternity Care

Measure Title

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

Measure Source

Healthy People 2010.

National Tables

1.73a Percent of liveborn infants with low birthweight (less than 2,500 grams), United States, 1998 and 2004.

1.73b Percent of liveborn infants with very low birthweight (less than 1,500 grams), United States, 1998 and 2004.

National Data Source

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

National Denominator

Number of live births.

National Numerator

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

State Tables

1.73c Percent of liveborn infants with low birthweight (less than 2,500 grams), by State, 1998 and 2004.

1.73d Percent of liveborn infants with very low birthweight (less than 1,500 grams), by State, 1998 and 2004.

State Data Source

CDC, NCHS, NVSS-N.

State Denominator

Population by State.

State Numerator

Same as national.

Comments

This measure is referred to as measure 16-10 in Healthy People 2010 documentation.

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Maternity Care

Measure Title

Infant mortality per 1,000 live births.

Measure Source

Healthy People 2010.

National Tables

1.74a Infant mortality per 1,000 live births, all birthweights, United States, 1998 and 2004.

1.74b Infant mortality per 1,000 live births, birthweight < 1,500 grams, United States, 2002 and 2004.

1.74c Infant mortality per 1,000 live births, birthweight 1,500-2,499 grams, United States, 2002 and 2004.

1.74d Infant mortality per 1,000 live births, birthweight > 2,499 grams, United States, 2002 and 2004.

National 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 (NVSS-I).

National Denominator

Resident live births.

National Numerator

Number of infant deaths within the first year.

State Tables

1.74e Infant mortality per 1,000 live births, all birthweights, by State, 1998 and 2004.

1.74f Infant mortality per 1,000 live births, birthweight < 1,500 grams, by State, 2002 and 2004.

1.74g Infant mortality per 1,000 live births, birthweight 1,500-2,499 grams, by State, 2002 and 2004.

1.74h Infant mortality per 1,000 live births, birthweight > 2,499 grams, by State, 2002 and 2004.

State Data Source

CDC, NCHS, NVSS-I.

State Denominator

Population by State.

State Numerator

Same as national.

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 age 1 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 that cannot be linked to their corresponding birth certificates.

This measure is referred to as measure 16-1c in Healthy People 2010 documentation.

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Maternity Care

Measure Title

Maternal deaths per 100,000 live births.

Measure Source

Healthy People 2010.

National Tables

1.75a Maternal deaths per 100,000 live births, United States, 1999 and 2004.

National Data Source

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

National Denominator

Resident live births.

National Numerator

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

State Tables

1.75b Maternal deaths per 100,000 live births, by State, 1999 and 2004.

State Data Source

CDC, NCHS, NVSS-M.

State Denominator

Population by State.

State Numerator

Same as national.

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.

This measure is referred to as measure 16-4 in Healthy People 2010 documentation.

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Immunization, Childhood

Measure Title

Children 19-35 months who received all recommended vaccines.

Measure Source

Healthy People 2010.

National Tables

1.76a Percent of children ages 19-35 months who received all recommended vaccines (4:3:1:3:3), United States, 1998 and 2005.

National Data Source

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

National Denominator

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

National Numerator

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

State Tables

1.76b Percent of children ages 19-35 months who received all recommended vaccines (4:3:1:3:3), by State, 2000 and 2005.

State Data Source

CDC, NCHS, NIS.

State Denominator

Same as national.

State Numerator

Same as national.

Comments

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

This measure is referred to as measure 14-24a in Healthy People 2010 documentation.

The vaccines included in this measure are based on the corresponding Healthy People 2010 objective. These include at least 4 doses of diphtheria, tetanus, and pertussis vaccine; at least 3 doses of polio vaccine; at least 1 dose of measles, mumps, and rubella vaccine; at least 3 doses of H. influenzae type B vaccine; and at least 3 doses of hepatitis B vaccine. Between 1998 and 2005, the following vaccines were added to the list of recommended vaccines for children up to 35 months of age but not added to this measure: pneumococcal conjugate vaccine (PCV) added in 2001 and influenza vaccine added in 2004. Varicella vaccine and vaccines added after 1998 to the recommended schedule for children up to 35 months of age are not included in this measure.

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Treatment of Pediatric Gastroenteritis

Measure Title

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

Measure Source

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

National Tables

1.77a Admissions for pediatric gastroenteritis (excluding patients with gastrointestinal abnormalities or bacterial gastroenteritis and transfers from other institutions) per 100,000 population, ages 0-17, United States, 2003 and 2004.

National Data Source

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

National Denominator

U.S. population under age 18.

National 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.

State Tables

1.77b Admissions for pediatric gastroenteritis (excluding patients with gastrointestinal abnormalities or bacterial gastroenteritis and transfers from other institutions) per 100,000 population, ages 4 months to 17 years, by State, 2003 and 2004.

State Data Source

AHRQ, CDOM, HCUP, State Inpatient Databases (SID).

State Denominator

Same as national.

State Numerator

Same as national.

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 PQI software. This measure is referred to as indicator 6 in the PQI 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

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).

Tables

1.78a Percent of children under age 18 who had their height and weight measured by a doctor or other health provider, United States, 2004.

1.78b Percent of children under age 18 who had their height and weight measured by a doctor or other health provider, United States, 2002.

Data Source

AHRQ, CFACT, Medical Expenditure Panel Survey (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 health care 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, within either 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

Children ages 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).

Tables

1.79a Percent of children ages 2-17 for whom a doctor or other health provider gave advice about amount and kind of physical activity, United States, 2004.

1.79b Percent of children ages 2-17 for whom a doctor or other health provider gave advice about amount and kind of physical activity, United States, 2002.

Data Source

AHRQ, CFACT, Medical Expenditure Panel Survey (MEPS).

Denominator

Children ages 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 ages 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

Children ages 2-17 for whom a doctor or other health provider gave advice about healthy eating.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT).

Tables

1.80a Percent of children ages 2-17 for whom a doctor or other health provider gave advice about healthy eating, United States, 2004.

1.80b Percent of children ages 2-17 for whom a doctor or other health provider gave advice about healthy eating, United States, 2002.

Data Source

AHRQ, CFACT, Medical Expenditure Panel Survey (MEPS).

Denominator

Children ages 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 ages 2-17 for whom a doctor or other health provider had ever given advice about healthy eating 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

Children ages 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).

Tables

1.81 Percent of children ages 3-6 whose vision was ever checked by a doctor or other health provider, United States, 2002 and 2004.

Data Source

AHRQ, CFACT, Medical Expenditure Panel Survey (MEPS).

Denominator

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

Numerator

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

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Childhood Preventive Care

Measure Title

Children ages 2-17 with a dental visit in the last year.

Measure Source

Healthy People 2010.

Tables

1.82 Percent of children ages 2-17 with a dental visit in the past year, United States, 2002 and 2004.

Data Source

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

Denominator

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

Numerator

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

Comments

This measure is referred to as measure 21-10 in Healthy People 2010 documentation.

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Childhood Preventive Care

Measure Title

Children with untreated dental caries.

Measure Source

Healthy People 2010.

Tables

1.83a Percent of children ages 2-5 with untreated dental caries, United States, 1988-1994 and 1999-2004.

1.83b Percent of children ages 6-11 with untreated dental caries, United States, 1988-1994 and 1999-2004.

1.83c Percent of children ages 12-17 with untreated dental caries, United States, 1988-1994 and 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

Children aged 2-4, 6-11,and 12-17 years, respectively.

Numerator

Subset of denominator with a clinical diagnosis of dental decay in at least one tooth that has not been restored.

Comments

This measure is referred to as measure 21-2 in Healthy People 2010 documentation. The age ranges have been modified from the original specification.

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Childhood Preventive Care

Measure Title

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).

Tables

1.84a 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, 2004.

1.84b 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, 2002.

Data Source

AHRQ, CFACT, Medical Expenditure Panel Survey (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

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).

Tables

1.85a Percent of children under age 18 for whom a doctor or other health provider gave advice about using car safety restraints, United States, 2004.

1.85b Percent of children under age 18 for whom a doctor or other health provider gave advice about using car safety restraints, United States, 2002.

Data Source

AHRQ, CFACT, Medical Expenditure Panel Survey (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

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).

Tables

1.86a Percent of children ages 2-17 for whom a doctor or other health provider gave advice about using a helmet when riding a bicycle or motorcycle, United States, 2004.

1.86b Percent of children ages 2-17 for whom a doctor or other health provider gave advice about using a helmet when riding a bicycle or motorcycle, United States, 2002.

Data Source

AHRQ, CFACT, Medical Expenditure Panel Survey (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 ages 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

Overweight children and teens ages 2-19 who were told by a doctor or health professional they were overweight.

Measure Source

Healthy People 2010.

Tables

1.87 Percent of overweight children and teens ages 2-19 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 ages 2-19 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.

Comments

This measure is referred to as measure 19-3c in Healthy People 2010 documentation.

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