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National Healthcare Quality Report, 2007

Effectiveness of Care: Respiratory Diseases

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Immunization, Influenza
High-risk persons (e.g., with chronic obstructive pulmonary disease) age 18-64 who received an influenza vaccination in the past 12 months
Persons age 65 and over who received an influenza vaccination in the past 12 months
Hospital admissions for immunization-preventable influenza per 100,000 population age 65 and over
Immunization, Pneumonia
High-risk persons (e.g., with chronic obstructive pulmonary disease) ages 18-64 who ever received a pneumococcal vaccination
Persons age 65 and over who ever received a pneumococcal vaccination
Treatment of Pneumonia
Composite measure: Pneumonia patients who received recommended hospital care for pneumonia (blood cultures collected before antibiotics are administered, received the initial antibiotic dose within 4 hours of hospital arrival and consistent with current recommendations, and received screening for influenza and pneumococcal disease vaccination status and vaccination, if indicated)
Patients with pneumonia who have blood cultures collected before antibiotics are administered
Patients with pneumonia who receive the initial antibiotic dose within 4 hours of hospital arrival
Patients with pneumonia who receive the initial antibiotic consistent with current recommendations
Patients with pneumonia who receive influenza screening or vaccination
Patients with pneumonia who receive pneumococcal screening or vaccination
Pneumonia mortality rate (number of deaths per 1,000 discharges for pneumonia)
Treatment of Upper Respiratory Infection
Visit rates where antibiotics were prescribed for a diagnosis of common cold per 10,000 population
Management of Asthma
Hospital admissions for pediatric asthma (under age 18)
Hospital admissions for asthma age 18 and over
Hospital admissions for asthma age 65 and over
Treatment of Tuberculosis
Tuberculosis patients that complete a curative course of TB treatment within 12 months of initiation of treatment

Immunization, Influenza

Measure Title

High-risk persons (e.g., with chronic obstructive pulmonary disease) age 18-64 who received an influenza vaccination in the past 12 months.

Measure Source

Healthy People 2010.

National Tables

1.96a Percent of high-risk persons ages 18-64 who received an influenza vaccination in the past 12 months, United States, 1999 and 2005.

National Data Source

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

National Denominator

U.S. population: high-risk adults age 18-64.

National Numerator

A subset of denominator who report receiving an influenza vaccination in the past 12 months.

State Tables

1.96b Percent of high-risk persons ages 18-64 who received an influenza vaccination in the past 12 months, by State, 2001 and 2005.

State Data Source

CDC, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Number of high-risk persons ages 18-64.

State Numerator

Number of high-risk persons ages 18-64 who answered "Yes" to the question "During the past 12 months, have you had a flu shot?"

Comments

High-risk conditions include diabetes, heart disease, lung disease, kidney disease, liver disease, and cancer. Not all high-risk conditions for complications of influenza and pneumococcal disease can be ascertained by NHIS (e.g., immunocompromised), and the sample size may be too small for some groups.

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.

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

This measure is referred to as measure 14-29c in Healthy People 2010 documentation.

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Immunization, Influenza

Measure Title

Persons age 65 and over who received an influenza vaccination in the past 12 months.

Measure Source

Healthy People 2010.

National Tables

1.97a Percent of persons age 65 and over who received an influenza vaccination in the past 12 months, United States, 1999 and 2005.

National Data Source

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

National Denominator

U.S. population age 65 and over.

National Numerator

Number of adults age 65 and over who report receiving an influenza vaccination in the past 12 months.

State Tables

1.97b Percent of persons age 65 and over who received an influenza vaccination in the past 12 months, by State, 2001 and 2005.

State Data Source

CDC, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Number of adults age 65 and over.

State Numerator

Number of adults age 65 and over who reported receiving an influenza vaccination in the past 12 months.

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.

Race categories in the national table have changed since 2001. Data for 2001 and later years may not be comparable with data from previous years.

This measure is referred to as measure 14-29a in Healthy People 2010 documentation.

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Immunization, Influenza

Measure Title

Hospital admissions for immunization-preventable influenza per 100,000 population age 65 and over.

Measure Source

Healthy People 2010.

National Tables

1.98a Immunization-preventable influenza admissions (excluding transfers from other institutions) per 100,000 population, age 65 and over, United States, 2003 and 2004.

National Data Source

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

National Denominator

U.S. population age 65 and over.

National Numerator

Non-maternal hospital discharges age 65 and over with any diagnosis of immunization-preventable influenza (ICD-9-CM codes 487.0, 487.1, and 487.8), excluding transfers from other institutions.

State Tables

1.98b Immunization-preventable influenza admissions (excluding transfers from other institutions) per 100,000 population, age 65 and over, 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 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.

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.

This measure is referred to as measure 1-9c in Healthy People 2010 documentation.

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Immunization, Pneumonia

Measure Title

High-risk persons (e.g., with chronic obstructive pulmonary disease) ages 18-64 who ever received a pneumococcal vaccination.

Measure Source

Healthy People 2010.

National Tables

1.99a Percent of high-risk persons ages 18-64 who ever received a pneumococcal vaccination, United States, 1999 and 2005.

National Data Source

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

National Denominator

U.S. population: high-risk persons ages 18-64.

National Numerator

A subset of the denominator who answered "Yes" to the question "Have you ever had a pneumonia vaccination, sometimes called a pneumonia shot? This shot is usually given only once in a person's lifetime and is different from the flu shot."

State Tables

1.99b Percent of high-risk persons ages 18-64 who ever received a pneumococcal vaccination, by State, 2001 and 2005.

State Data Source

CDC, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Number of high-risk persons ages 18-64.

State Numerator

Number of high-risk persons ages 18-64 who answered "Yes" to the question "Have you ever had a pneumonia vaccination?"

Comments

See Appendix H of Tracking Healthy People 2010 for a complete listing of Leading Health Indicators. High-risk conditions include diabetes, heart disease, lung disease, kidney disease, liver disease, and cancer.

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.

Race categories in the national table have changed since 2001. Data for 2001 and later years may not be comparable with data from previous years.

This measure is referred to as measure 14-29d in Healthy People 2010 documentation.

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Immunization, Pneumonia

Measure Title

Persons age 65 and over who ever received a pneumococcal vaccination.

Measure Source

Healthy People 2010.

National Tables

1.100a Percent of adults age 65 and over who ever received a pneumococcal vaccination, United States, 1999 and 2005.

National Data Source

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

National Denominator

U.S. population: age 65 and over.

National Numerator

Number of adults age 65 and over who had a pneumonia vaccination.

State Tables

1.100b Percent of adults age 65 and over who ever received a pneumococcal vaccination, by State, 2001 and 2005.

State Data Source

CDC, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Number of adults age 65 and over.

State Numerator

Number of adults age 65 and over who had a pneumonia vaccination.

Comments

Race categories in the national table have changed since 2001. Data for 2001 and later years may not be comparable with data from previous years.

State Tables are age adjusted to the 2000 standard population.

This measure is referred to as measure 14-29b in Healthy People 2010 documentation.

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Treatment of Pneumonia

Measure Title

Composite measure: Pneumonia patients who received recommended hospital care for pneumonia (blood cultures collected before antibiotics are administered, received the initial antibiotic dose within 4 hours of hospital arrival and consistent with current recommendations, and received screening for influenza and pneumococcal disease vaccination status and vaccination, if indicated).

Measure Source

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

National Tables

1.101a Percent of pneumonia patients who received recommended hospital care, United States, 2005.

National Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

National Denominator

Medicare hospital discharges age 65 and over meeting either of the following criteria: (1) principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2) secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (acute or chronic, ICD-9-CM code 518.81).

National Numerator

Subset instances in which the denominator population received recommended care, if indicated and appropriate: blood cultures collected before antibiotics are administered, initial antibiotic dose within 4 hours of hospital arrival and consistent with current recommendations, and influenza and pneumococcal screening or vaccination.

State Tables

1.101b Percent of pneumonia patients who received recommended hospital care, by State, 2005.

1.101c Percent of pneumonia patients who received recommended hospital care, by State, 2006.

State Data Source

CMS, Hospital Compare (HC).

State Denominator

Same as national.

State Numerator

Same as national.

Comments

Further information about this and other pneumonia measures is available at http://www.cms.hhs.gov/HospitalQualityInits/.

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Treatment of Pneumonia

Measure Title

Patients with pneumonia who have blood cultures collected before antibiotics are administered.

Measure Source

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

National Tables

1.102a Percent of pneumonia patients who had blood cultures collected before antibiotics were administered, United States, 2005.

National Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

National Denominator

Discharged hospital patients with a blood culture performed meeting either of the following criteria: (1) principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2) secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (acute or chronic, ICD-9-CM code 518.81).

National Numerator

Subset of the denominator population who had blood cultures performed prior to antibiotic administration.

State Tables

1.102b Percent of pneumonia patients who had blood cultures collected before antibiotics were administered, by State, 2005.

1.102c Percent of pneumonia patients who had blood cultures collected before antibiotics were administered, all payers, by State, 2004 and 2006.

State Data Source

CMS, Hospital Compare (HC).

State Denominator

Same as national.

State Numerator

Same as national.

Comments

Further information about this and other pneumonia measures is available at http://www.cms.hhs.gov/HospitalQualityInits/.

The average percents in the State table were pre-calculated and supplied as part of the Hospital Compare database.

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Treatment of Pneumonia

Measure Title

Patients with pneumonia who receive the initial antibiotic dose within 4 hours of hospital arrival.

Measure Source

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

National Tables

1.103a Percent of pneumonia patients who received the first dose of antibiotic within 4 hours of arrival at the hospital, United States, 2005.

National Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

National Denominator

Discharged hospital patients meeting either of the following criteria: (1) principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2) secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (acute or chronic, ICD-9-CM code 518.81).

National Numerator

Subset of the denominator population who received their first dose of antibiotics within 4 hours after arrival at the hospital.

State Tables

1.103b Percent of pneumonia patients who received the first dose of antibiotic within 4 hours of arrival at the hospital, by State, 2005.

1.103c Percent of pneumonia patients who received the first dose of antibiotics within 4 hours of arrival at the hospital, all payers, by State, 2004 and 2006.

State Data Source

CMS, Hospital Compare (HC).

State Denominator

Same as national.

State Numerator

Same as national.

Comments

Further information about this and other pneumonia measures is available at http://www.cms.hhs.gov/HospitalQualityInits/.

The average percents in the State table were pre-calculated and supplied as part of the Hospital Compare database.

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Treatment of Pneumonia

Measure Title

Patients with pneumonia who receive the initial antibiotic consistent with current recommendations.

Measure Source

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

National Tables

1.104a Percent of immunocompetent pneumonia patients (either intensive care unit [ICU] or non-ICU) who received the recommended empirical antibiotic regimen during the first 24 hours consistent with current guidelines, United States, 2005.

National Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

National Denominator

Discharged hospital patients meeting either of the following criteria: (1)Principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2)Secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (acute or chronic, ICD-9-CM code 518.81)

National Numerator

Subset of the denominator population who received an initial antibiotic regimen consistent with current guidelines during the first 24 hours of their hospitalization.

State Tables

1.104b Percent of immunocompetent pneumonia patients (either ICU or non-ICU) who received the recommended empirical antibiotic regimen during the first 24 hours consistent with current guidelines, by State, 2005.

1.104c Percent of immunocompetent pneumonia patients (either ICU or non-ICU) who received the recommended empirical antibiotic regimen during the first 24 hours consistent with current guidelines, all payers, by State, 2005 and 2006.

State Data Source

CMS, Hospital Compare (HC).

State Denominator

Same as national.

State Numerator

Same as national.

Comments

Further information about this and other pneumonia measures is available at http://www.cms.hhs.gov/HospitalQualityInits/.

The average percents in the State table were pre-calculated and supplied as part of the Hospital Compare database.

The specification for the denominator of this measure has changed to exclude patients with health-care-associated pneumonia. Reported rates may not be comparable to those reported in earlier years of the NHQR.

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Treatment of Pneumonia

Measure Title

Patients with pneumonia who receive influenza screening or vaccination.

Measure Source

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

National Tables

1.105a Percent of pneumonia patients age 50 and over discharged during October-February who were screened for influenza vaccine status and were vaccinated prior to discharge, United States, 2005.

National Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

National Denominator

Medicare hospital discharges age 50 and over during October, November, December, January, and February meeting either of the following criteria: (1) principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2) secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (acute or chronic, ICD-9-CM code 518.81).

National Numerator

Subset of the denominator population who were screened for influenza vaccine status and were vaccinated prior to discharge, if indicated.

State Tables

1.105b Percent of pneumonia patients age 50 years and over discharged during October-February who were screened for influenza vaccine status and were vaccinated prior to discharge, by State, 2005.

1.105c Percent of pneumonia patients age 50 and over who were screened for influenza vaccine status and were vaccinated prior to discharge, if indicated, all payers, by State, 2006.

State Data Source

CMS, Hospital Compare (HC).

State Denominator

Same as national.

State Numerator

Same as national.

Comments

Further information about this and other pneumonia measures is available at http://www.cms.hhs.gov/HospitalQualityInits/.

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Treatment of Pneumonia

Measure Title

Patients with pneumonia who receive pneumococcal screening or vaccination.

Measure Source

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

National Tables

1.106a Percent of pneumonia patients age 65 and older who were screened for pneumococcal vaccine status and vaccinated prior to discharge, if indicated, United States, 2005.

National Data Source

CMS, Medicare Quality Improvement Organizations Program (QIO).

National Denominator

Discharged hospital patients age 65 and over meeting either of the following criteria: (1) principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2) secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (acute or chronic, ICD-9-CM code 518.81).

National Numerator

Subset of the denominator population who were screened for pneumococcal vaccine status and were vaccinated prior to discharge, if indicated.

State Tables

1.106b Percent of pneumonia patients age 65 and over who were screened for pneumococcal vaccine status and vaccinated prior to discharge, if indicated, by State, 2005.

1.106c Percent of pneumonia patients age 65 and over who were screened for pneumococcal vaccine status and vaccinated prior to discharge, if indicated, all payers, by State, 2004 and 2006.

State Data Source

CMS, Hospital Compare (HC).

State Denominator

Same as national.

State Numerator

Same as national.

Comments

Further information about this and other pneumonia measures is available at http://www.cms.hhs.gov/HospitalQualityInits/.

The average percents in the State table were pre-calculated and supplied as part of the Hospital Compare database.

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Treatment of Pneumonia

Measure Title

Pneumonia mortality rate (number of deaths per 1,000 discharges for pneumonia).

Measure Source

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

Tables

1.107 Deaths per 1,000 admissions with pneumonia as principal diagnosis (excluding obstetric and neonatal admissions and transfers to another hospital), age 18 and over, United States, 2003 and 2004.

Data Source

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

Denominator

All discharges age 18 and older with principal diagnosis code of pneumonia. Excludes patients transferring to another short-term hospital and obstetric and neonatal admissions.

Numerator

Number of deaths with a principal diagnosis code of pneumonia.

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. See Guide to Inpatient Quality Indicators at http://qualityindicators.ahrq.gov for a discussion of this measure, including a complete list of ICD-9-CM codes.

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.

This table was created using version 2.1, revision 3, of the AHRQ IQI software. This measure is referred to as indicator 20 in the software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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Treatment of Upper Respiratory Infection

Measure Title

Visit rates where antibiotics were prescribed for a diagnosis of common cold per 10,000 population.

Measure Source

Healthy People 2010.

Tables

1.108 Rate antibiotics prescribed at visits with a diagnosis of common cold per 10,000 population, United States, 2000-2001 and 2004-2005.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (NAMCS-NHAMCS).

Denominator

Number of hospital-based and office-based outpatient visits.

Numerator

Number of antibiotic courses ordered, supplied, administered, or continued at a specific visit for persons diagnosed with the common cold (ICD-9-CM codes 460.0, 465, or 472.0).

Comments

This measure is referred to as measure 14-19 in Healthy People 2010 documentation. The age range has been modified from the original specification.

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Management of Asthma

Measure Title

Hospital admissions for pediatric asthma (under age 18).

Measure Source

Healthy People 2010.

National Tables

1.110a Pediatric asthma admissions (excluding patients with cystic fibrosis or anomalies of the respiratory system and transfers from other institutions) per 100,000 population, ages 2-17, United States, 2003 and 2004.

National Data Source

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

National Denominator

U.S. population: children under age 18.

National Numerator

Number of discharges with principal diagnosis of asthma (ICD-9-CM code 493) among children under age 18, excluding obstetric and neonatal admissions and transfers from other institutions.

State Tables

1.110b Pediatric asthma admissions (excluding patients with cystic fibrosis or anomalies of the respiratory system and transfers from other institutions) per 100,000 population, ages 2-17, 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 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 4 in the AHRQ PQI software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

This measure is referred to as measure 24-2 in Healthy People 2010 documentation. The age range has been modified from the original specification.

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Management of Asthma

Measure Title

Hospital admissions for asthma age 18 and over.

Measure Source

Healthy People 2010.

National Tables

1.111a Asthma admissions (excluding patients with cystic fibrosis or anomalies of the respiratory system, obstetric admissions, and transfers from other institutions) per 100,000 population, age 18 and over, United States, 2003 and 2004.

National Data Source

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

National Denominator

U.S. population age 18 and over.

National Numerator

Number of discharges with first listed diagnosis of asthma (ICD-9-CM code 493) among adults age 18 and over. Excludes obstetric admissions and transfers from other institutions.

State Tables

1.111b Asthma admissions (excluding patients with cystic fibrosis or anomalies of the respiratory system, obstetric admissions, and transfers from other institutions) per 100,000 population, age 18 and over, 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 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 15 in the AHRQ PQI software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

This measure is referred to as measure 24-2 in Healthy People 2010 documentation. The age range has been modified from the original specification.

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Management of Asthma

Measure Title

Hospital admissions for asthma age 65 and over.

Measure Source

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

National Tables

1.112a Asthma admissions (excluding patients with cystic fibrosis or anomalies of the respiratory system, obstetric admissions, and transfers from other institutions) per 100,000 population, age 65 and over, 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 age 65 and over.

National Numerator

Non-maternal hospital discharges age 65 and over with a principal diagnosis code of asthma (ICD-9-CM codes 493.00-493.02, 493.10-493.12, 493.20-493.22, and 493.90-493.92). Excludes obstetric admissions and patients transferred from other institutions.

State Tables

1.112b Asthma admissions (excluding patients with cystic fibrosis or anomalies of the respiratory system, obstetric admissions, and transfers from other institutions) per 100,000 population, age 65 and over, by State, 2003 and 2004.

State Data Source

AHRQ, CDOM, HCUP, NIS.

State Denominator

Same as national.

State Numerator

Same as national.

Comments

Rates 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.

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 a modified version of indicator 15 in the AHRQ PQI software documentation. It excludes all patients under age 65. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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Treatment of Tuberculosis

Measure Title

Tuberculosis patients that complete a curative course of TB treatment within 12 months of initiation of treatment.

Measure Source

American Thoracic Society.

Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination.

Tables

1.113 Percent of tuberculosis patients who completed a curative course of treatment within 12 months of initiation of treatment, United States, 1998 and 2003.

Data Source

CDC, National Tuberculosis Surveillance System (NTBSS).

Denominator

U.S. resident population with verified tuberculosis (TB).

Numerator

TB cases completing therapy within 1 year.

Comments

See American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: Treatment of tuberculosis, Am J Respir Crit Care Med, 2003, Vol. 167 pp. 603-662, for further information regarding current tuberculosis treatment guidelines.

See Appendix A of CDC publication Reported Tuberculosis in the United States, 2000 for a discussion of completion of TB therapy.

Due to a change in the data source race variable effective in 2003, results have changed slightly from previous years' calculations.

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