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National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013

Access to Care: Health Care Utilization

 

Measures

People who had an office-based or outpatient department visit
People who received a prescription medication in the calendar year
People who had an emergency visit in the calendar year
People who received a hospital inpatient discharge in the calendar year
Physician office and hospital outpatient visits
Admissions with hypertension
Admissions for angina with cardiac procedure
Admissions for chronic obstructive pulmonary disease (COPD)
Admissions for bacterial pneumonia
Adults who received outpatient mental health treatment or counseling in the last 12 months
Adults who received prescription medications for mental health treatment in the last 12 months
Adults who received inpatient mental health treatment or counseling in the last 12 months
Adolescents and adults who needed treatment for illicit drug use or an alcohol problem and who received such treatment at a specialty facility in the last 12 months


 

Measure Title

People who had an office-based or outpatient department visit

Measure Source

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

Table Description

Geographic Representation

National

Years Available

2008, 2009, 2010

Population Subgroups

Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born

Data Sources

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

Denominator

U.S. civilian noninstitutionalized population

Numerator

Subset of the denominator who reported at least one office-based/outpatient department visit

Comments

Office-based/outpatient department visits include the following:

  • Office-based visits to physician and nonphysician providers.
  • Outpatient department visits to physician and nonphysician providers.
  • Inpatient visits where the admission date was the same as the discharge date (i.e., "zero-night" stays).

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Measure Title

People who received a prescription medication in the calendar year

Measure Source

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

Table Description

Geographic Representation

National

Years Available

2002 -2010

Population Subgroups

Activity limitation, age, education, employment status, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born

Data Sources

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

Denominator

U.S. civilian noninstitutionalized population

Numerator

Subset of the denominator who reported receiving at least one prescribed medication in the calendar year

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Measure Title

People who had an emergency visit in the calendar year

Measure Source

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

Table Description

Geographic Representation

National

Years Available

2002-2010

Population Subgroups

Activity limitations, age, education, employment status, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born

Data Sources

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

Denominator

U.S. civilian noninstitutionalized population

Numerator

Subset of the denominator who reported at least one emergency room visit during the calendar year

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Measure Title

People who received a hospital inpatient discharge in the calendar year

Measure Source

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

Table Description

Geographic Representation

National

Years Available

2002-2010

Population Subgroups

Activity limitations, age, education, employment status, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born

Data Sources

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

Denominator

U.S. civilian noninstitutionalized population

Numerator

Subset of the denominator who reported at least one inpatient discharge during the calendar year

Comments

Inpatient discharges exclude inpatient visits where the admission date was the same as the discharge date (i.e., "zero-night" stays).

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Measure Title

Physician office and hospital outpatient visits

Measure Source

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

Table Description

Geographic Representation

National

Years Available

1999-2010

Population Subgroups

Age, sex, race/ethnicity, location (hospital)

Data Sources

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

Denominator

U.S. civilian noninstitutionalized population

Numerator

Number of visits to physician offices and hospital outpatient departments among the population represented by the denominator

Comments

Population used for calculation is U.S. Census Bureau estimated civilian noninstitutionalized population on July 1 each year. Ambulatory medical care visits include visits to office-based physicians, community health centers, and hospital outpatient departments. For consistency with previous years, visits to midlevel providers at community health centers were excluded.

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Measure Title

Admissions with hypertension

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Prevention Quality Indicators (PQIs)

Table Description

Geographic Representation

National, State

Years Available

National: 2000-2010

State: 2000-2010

Population Subgroups

Age, geographic location (residence), income, region, sex

Data Sources

State

AHRQ, CDOM, HCUP, Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, modified version 4.1

National

AHRQ, CDOM, HCUP, State Inpatient Databases (SID) and AHRQ Quality Indicators, modified version 4.1

Denominator

U.S. population age 18 and over

Numerator

Subset of the denominator with principal diagnosis of hypertension, excluding patients with cardiac procedures, obstetric admissions, and transfers from other institutions

Comments

Consistent with the AHRQ PQI software, hypertension must be the principal diagnosis. Excluded from this measure are admissions for kidney disease access procedures, admissions with cardiac procedures, and transfers from other institutions.

Rates are adjusted by age and gender using the total U.S. resident population for 2000 as the U.S. 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, NIS is weighted to give national estimates using weights based on all U.S. community, nonrehabilitation hospitals in the American Hospital Association Annual Survey Database.

SID includes a powerful set of hospital databases from data organizations in participating States. SID contains the universe of the inpatient discharge abstracts in participating States, translated into a uniform format to facilitate multistate comparisons and analyses. Together, SID encompasses about 90% of all U.S. community hospital discharges. SID contains a core set of clinical and nonclinical information on all patients, regardless of payer, including people covered by Medicare, Medicaid, and private insurance, as well as uninsured people. In addition to the core set of uniform data elements common to all SID, some databases within SID include other elements, such as the patient’s race.

The SID disparities analysis file is designed to provide national estimates on disparities using weighted records from a sample of hospitals from the following 37 States: AK, AR, AZ, CA, CO, CT, FL, GA, HI, IA, IL, IN, KS, KY, MA, MD, MI, MO, MS, NC, NJ, NM, NV, NY, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WI, and WY.

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Measure Title

Admissions for angina with cardiac procedure

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Prevention Quality Indicators (PQIs)

Table Description

Geographic Representation

National, State

Years Available

National: 2000-2010

State: 2000-2010

Population Subgroups

Age, geographic location (residence), income, race/ethnicity, region, sex

Data Sources

National

AHRQ, CDOM, HCUP, Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, modified version 4.1

State

AHRQ, CDOM, HCUP, State Inpatient Databases (SID) disparities analysis file, and AHRQ Quality Indicators, modified version 4.1

Denominator

U.S. population age 18 and over

Numerator

Subset of the denominator with principal diagnosis of angina, excluding patients with cardiac procedures, obstetric admissions, and transfers from other institutions

Comments

Consistent with the AHRQ PQI software, angina must be the principal diagnosis, and transfers from other institutions are excluded.

Rates are adjusted by age and gender using the total U.S. resident 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, NIS is weighted to give national estimates using weights based on all U.S. community, nonrehabilitation hospitals in the American Hospital Association Annual Survey Database.

SID includes a powerful set of hospital databases from data organizations in participating States. SID contains the universe of the inpatient discharge abstracts in participating States, translated into a uniform format to facilitate multistate comparisons and analyses. Together, SID encompasses about 90% of all U.S. community hospital discharges. SID contains a core set of clinical and nonclinical information on all patients, regardless of payer, including people covered by Medicare, Medicaid, and private insurance, as well as uninsured people. In addition to the core set of uniform data elements common to all SID, some databases within SID include other elements, such as the patient’s race.

The SID disparities analysis file is designed to provide national estimates on disparities using weighted records from a sample of hospitals from the following 37 States: AK, AR, AZ, CA, CO, CT, FL, GA, HI, IA, IL, IN, KS, KY, MA, MD, MI, MO, MS, NC, NJ, NM, NV, NY, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WI, and WY.

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Measure Title

Admissions for chronic obstructive pulmonary disease (COPD)

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Prevention Quality Indicators (PQIs)

Table Description

Geographic Representation

National, State

Years Available

National–2000-2010

State–2000-2010

Population Subgroups

Age, geographic location (residence), income, race/ethnicity, region, sex

Data Sources

National

AHRQ, CDOM, HCUP, Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, modified version 4.1

State

AHRQ, CDOM, HCUP, State Inpatient Databases (SID) disparities analysis file, and AHRQ Quality Indicators, modified version 4.1

Denominator

U.S. population age 18 and over

Numerator

Subset of the denominator with principal diagnosis of COPD, excluding obstetric admissions and transfers from other institutions

Comments

Consistent with the AHRQ PQI software, angina must be the principal diagnosis, and transfers from other institutions are excluded.

Rates are adjusted by age and gender using the total U.S. resident 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, NIS is weighted to give national estimates using weights based on all U.S. community, nonrehabilitation hospitals in the American Hospital Association Annual Survey Database.

SID includes a powerful set of hospital databases from data organizations in participating States. SID contains the universe of the inpatient discharge abstracts in participating States, translated into a uniform format to facilitate multistate comparisons and analyses. Together, SID encompasses about 90% of all U.S. community hospital discharges. SID contains a core set of clinical and nonclinical information on all patients, regardless of payer, including people covered by Medicare, Medicaid, and private insurance, as well as uninsured people. In addition to the core set of uniform data elements common to all SID, some databases within SID include other elements, such as the patient’s race.

The SID disparities analysis file is designed to provide national estimates on disparities using weighted records from a sample of hospitals from the following 37 States: AK, AR, AZ, CA, CO, CT, FL, GA, HI, IA, IL, IN, KS, KY, MA, MD, MI, MO, MS, NC, NJ, NM, NV, NY, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WI, and WY.

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Measure Title

Admissions for bacterial pneumonia

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Prevention Quality Indicators (PQIs)

Table Description

Geographic Representation

National, State

Years Available

National:2000-2010

State–2000-2010

Population Subgroups

Age, geographic location (residence), income, race/ethnicity, region, sex

Data Sources

National

AHRQ, CDOM, HCUP, Nationwide Inpatient Sample (NIS), and AHRQ Quality Indicators, modified version 4.1

State

AHRQ, CDOM, HCUP, State Inpatient Databases (SID) disparities analysis file, and AHRQ Quality Indicators, modified version 4.1

Denominator

U.S. population age 18 and over

Numerator

Subset of the denominator with a principal diagnosis of bacterial pneumonia, excluding sickle cell or hemoglobin-S conditions, obstetric admissions, and transfers from other institutions

Comments

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

Consistent with the AHRQ PQI software, bacterial pneumonia must be the principal diagnosis. Admissions for sickle cell disease and transfers from other institutions are excluded.

Although not all States participate in the HCUP database, NIS is weighted to give national estimates using weights based on all U.S. community, nonrehabilitation hospitals in the American Hospital Association Annual Survey Database.

SID includes a powerful set of hospital databases from data organizations in participating States. SID contains the universe of the inpatient discharge abstracts in participating States, translated into a uniform format to facilitate multistate comparisons and analyses. Together, SID encompasses about 90% of all U.S. community hospital discharges. SID contains a core set of clinical and nonclinical information on all patients, regardless of payer, including people covered by Medicare, Medicaid, and private insurance, as well as uninsured people. In addition to the core set of uniform data elements common to all SID, some databases within SID include other elements, such as the patient’s race.

The SID disparities analysis file is designed to provide national estimates on disparities using weighted records from a sample of hospitals from the following 37 States: AK, AR, AZ, CA, CO, CT, FL, GA, HI, IA, IL, IN, KS, KY, MA, MD, MI, MO, MS, NC, NJ, NM, NV, NY, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WI, and WY.

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Measure Title

Adults who received outpatient mental health treatment or counseling in the last 12 months

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH)

Table Description

Geographic Representation

National, State

Years Available

National: 2002-2011

State: 2011

Population Subgroups

Age, education, income, location (residence), race/ethnicity, sex

Data Sources

National and State

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH)

Denominator

U.S. civilian noninstitutionalized population age 18 and over

Numerator

Subset of the denominator who reported receipt of outpatient mental health treatment or counseling in the past year

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Measure Title

Adults who received prescription medications for mental health treatment in the last 12 months

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH)

Table Description

Geographic Representation

National, State

Years Available

National: 2002-2011

State: 2011

Population Subgroups

Age, education, income, location (residence), race/ethnicity, sex

Data Sources

National and State

Substance Abuse and Mental Health Services SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH)

Denominator

U.S. civilian noninstitutionalized population age 18 and over

Numerator

Subset of the denominator who reported receipt of counseling or prescription medications for treatment of a mental health condition or problem in the past year

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Measure Title

Adults who received inpatient mental health treatment or counseling in the last 12 months

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH)

Table Description

Geographic Representation

National, State

Years Available

National: 2002-2011

State: 2011

Population Subgroups

Age, education, income, location (residence), race/ethnicity, sex

Data Sources

National and State

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH)

Denominator

U.S. civilian noninstitutionalized population age 18 and over

Numerator

Subset of the denominator who reported receipt of inpatient mental health treatment or counseling in the past year

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Measure Title

Adolescents and adults who needed treatment for illicit drug use or an alcohol problem and who received such treatment at a specialty facility in the last 12 months

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH)

Table Description

Geographic Representation

National, State

Years Available

National: 2002-2011

State: 2011

Population Subgroups

Age, education, income, location (residence), race/ethnicity, sex

Data Sources

National and State

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH)

Denominator

U.S. civilian noninstitutionalized population age 12 and over who needed treatment for any illicit drug use or alcohol problem

Numerator

Subset of the denominator who received treatment for illicit drug use or alcohol problem at a specialty facility in the last 12 months

Comments

Respondents were classified as needing treatment for an illicit drug or alcohol problem if they met at least one of three criteria during the past year: (1) dependent on illicit drugs or alcohol; (2) abuse of illicit drugs or alcohol; or (3) received treatment for an illicit drug or alcohol problem at a specialty facility (i.e., drug and alcohol rehabilitation facilities [inpatient or outpatient], hospitals [inpatient only], and mental health centers).

Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics (nonmedical use) (based on data from original questions) not including methamphetamine items added in 2005 and 2006.

Receipt of illicit drug or alcohol treatment at a specialty facility refers to treatment received at a hospital (inpatient), a rehabilitation facility (inpatient or outpatient), or mental health center in order to reduce or stop illicit drug or alcohol use, or for medical problems associated with illicit drug or alcohol use.

Estimates include people who received treatment specifically for illicit drugs or alcohol, as well as people who received treatment but did not specify for what substances.

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Page last reviewed July 2014
Page originally created July 2014
Internet Citation: National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013. Content last reviewed July 2014. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/research/findings/nhqrdr/nhqrdr13/measurespec/access-utilization.html

 

The information on this page is archived and provided for reference purposes only.

 

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