National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013
Measures
Deaths per 1,000 adult hospital admissions with acute myocardial infarction (AMI)
Hospital admissions for congestive heart failure (CHF) per 100,000 population
Deaths per 1,000 adult hospital admissions with congestive heart failure (CHF)
Deaths per 1,000 adult hospital admissions with abdominal aortic aneurysm (AAA) repair
Heart failure patients with left ventricular systolic dysfunction (LVSD) who were prescribed angiotensin-converting-enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB) at hospital discharge
Deaths per 1,000 hospital admissions with coronary artery bypass surgery (CABG), age 40 and over
Deaths per 1,000 hospital admissions with percutaneous transluminal coronary angioplasty (PTCA), age 40 and over
Adults with controlled hypertension
Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high
Adults who received a blood cholesterol measurement in the last 5 years
Measure Title
Deaths per 1,000 adult hospital admissions with acute myocardial infarction (AMI)
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Centers for Delivery Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Inpatient Quality Indicators (IQIs)
Table Description
Geographic Representation
National, State
Years Available
State: 2000-2010
National: 2000-2001; 2004-2010
Population Subgroups
Age, sex, bed size of hospital, insurance, location of hospital, location of residence, median income of patients zip code, control of hospital, region, teaching status of hospital
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)
Denominator
All hospital inpatient discharges among people age 18 and over with a principal diagnosis of AMI. Excluded from the denominator are obstetric admissions and patients transferring to another short-term hospital or missing a discharge disposition.
Numerator
Subset of the denominator who died
Comments
Rates are adjusted by age, major diagnostic category (MDC), all patient refined-diagnosis related group (APR-DRG) risk of mortality score, and transfers to the hospital. When reporting is by age, the adjustment is by MDC, APR-DRG risk of mortality score, and transfers to the hospital. The AHRQ IQI software was modified to not use the present on admission (POA) indicators (or estimates of the likelihood of POA for secondary diagnosis).
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.
Measure Title
Hospital admissions for congestive heart failure (CHF) per 100,000 population
Measure Source
Healthy People 2020; 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
State: 2000; 2004; 2007-2010
National: 2000-2001; 2004; 2007-2010
Population Subgroups
Age, sex, income, location of residence, region
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)
Denominator
U.S. population in metropolitan area or county, age 18 years and over
Numerator
Subset of the denominator with a principal diagnosis of CHF, excluding maternal discharges, transfers from other institutions, and cases with cardiac procedure codes
Comments
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.
This measure is referred to as measure HDS-24 in Healthy People 2020 documentation. The age range has been modified from the original specification.
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.
Measure Title
Deaths per 1,000 adult hospital admissions with congestive heart failure (CHF)
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Inpatient Quality Indicators (IQIs).
Table Description
Geographic Representation
National, State
Years Available
State: 2000; 2004; 2007-2010
National: 2000-2001; 2004-2010
Population Subgroups
Age, sex, bed size of hospital, insurance, location of hospital, location of residence, median income of patients zip code, control of hospital, region, teaching status of hospital
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)
Denominator
All discharges among people age 18 and over with principal diagnosis code of CHF, excluding transfers to another short-term hospital, obstetric admissions, and cases with a missing discharge disposition
Numerator
Subset of the denominator who died
Comments
Rates are adjusted by age, gender, age-gender interactions, major diagnostic category (MDC), all patient refined-diagnosis related group (APR-DRG) risk of mortality score, and transfers to the hospital. When reporting is by age, the adjustment is by gender, MDC, APR-DRG risk of mortality score, and transfers to the hospital; when reporting is by gender, the adjustment is by age, MDC, APR-DRG risk of mortality score, and transfers to the hospital. The AHRQ IQI software was modified to not use the present on admission (POA) indicators (or estimates of the likelihood of POA for secondary diagnosis).
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.
Measure Title
Deaths per 1,000 adult hospital admissions with abdominal aortic aneurysm (AAA) repair
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Inpatient Quality Indicators (IQIs).
Table Description
Geographic Representation
National, State
Years Available
State: 2000; 2004; 2007-2010
National: 2000-2001; 2004-2010
Population Subgroups
Age, sex, bed size of hospital, insurance, location of hospital, location of residence, median income of patients zip code, control of hospital, region, teaching status of hospital
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)
Denominator
Discharges age 18 years and over with an AAA repair code in any procedure field and a diagnosis of AAA in any field, excluding obstetric admissions, transfers to another short-term hospital, and cases with a missing discharge disposition
Numerator
Subset of the denominator who died
Comments
Rates are adjusted by age, gender, age-gender interactions, major diagnostic category (MDC), and all patient refined-diagnosis related group (APR-DRG) risk of mortality score. When reporting is by age, the adjustment is by gender, MDC, and APR-DRG risk of mortality score; when reporting is by gender, the adjustment is by age, MDC, and APR-DRG risk of mortality score. The AHRQ IQI software was modified to not use the present on admission (POA) indicators (or estimates of the likelihood of POA for secondary diagnosis).
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.
Measure Title
Heart failure patients with left ventricular systolic dysfunction (LVSD) who were prescribed angiotensin-converting-enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB) at hospital discharge
Measure Source
Centers for Medicare & Medicaid Services (CMS) Quality Improvement Organization (QIO) Hospital Inpatient Quality Reporting (HIQR) Program
Table Description
Geographic Representation
National, State
Years Available
National: 2005-2011
State: 2005-2011
Population Subgroups
Age, race/ethnicity, sex
Data Sources
National & State
Centers for Medicare & Medicaid Services (CMS) Quality Improvement Organization (QIO) Clinical Data Warehouse (CDW) for Hospital Inpatient Quality Reporting (HIQR) Program
Denominator
Discharged hospital patients age 18 and over with a principal diagnosis of heart failure and documented left ventricular ejection fraction, without contraindications for ACE inhibitors or ARB, excluding patients transferred to another acute care or Federal hospital, patients who died, patients who left against medical advice, patients discharged to hospice, and patients with certain conditions or contraindications pertaining to the medications described in the measure
Numerator
Subset of the denominator prescribed an ACE inhibitor or ARB at hospital discharge with no documentation of ACE inhibitor allergy or ARB allergy, moderate or severe aortic stenosis, or other reasons documented by a physician, advanced practice nurse, or physician assistant for not prescribing an ACE inhibitor or ARB at discharge
Comments
Estimates for 2011 do not include data from the U.S. territories (Guam, Puerto Rico, and Virgin Islands); estimates for other years do not include data from Guam and the U.S. Virgin Islands. Further information on this and other heart disease measures is available at http://www.cms.hhs.gov/HospitalQualityInits/.
Measure Title
Deaths per 1,000 hospital admissions with coronary artery bypass graft surgery (CABG), age 40 and over
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Inpatient Quality Indicators (IQIs).
Table Description
Geographic Representation
National, State
Years Available
State: 2000; 2004; 2007-2010
National: 2000-2001; 2004-2010
Population Subgroups
Age, sex, bed size of hospital, insurance, location of hospital, location of residence, median income of patients’ zip code, control of hospital, region, teaching status
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)
Denominator
Hospital inpatient discharges, age 40 and over, with a CABG in any procedure field, excluding obstetric admissions and transfers to another hospital
Numerator
Subset of the denominator who died
Comments
Rates are adjusted by age, gender, age-gender interactions, major diagnostic category (MDC), and all patient refined-diagnosis related group (APR-DRG) risk of mortality score. When reporting is by age, the adjustment is by gender, MDC, and APR-DRG risk of mortality score; when reporting is by gender, the adjustment is by age, MDC, and APR-DRG risk of mortality score. The AHRQ IQI software was modified to not use the present on admission (POA) indicators (or estimates of the likelihood of POA for secondary diagnosis).
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.
Measure Title
Deaths per 1,000 hospital admissions with percutaneous transluminal coronary angioplasty (PTCA), age 40 and over
Measure Source
Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Inpatient Quality Indicators (IQIs).
Table Description
Geographic Representation
National, State
Years Available
State: 2000; 2004; 2007-2010
National: 2000-2001; 2004-2010
Population Subgroups
Age, sex, bed size of hospital, insurance, location of hospital, location of residence, median income of patients zip code, control of hospital, region, teaching status of hospital
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)
Denominator
Hospital inpatient discharges, age 40 and over, with PTCA in any procedure field, excluding obstetric admissions, transfers to another hospital, and cases with a missing discharge disposition
Numerator
Subset of the denominator who died
Comments
Rates are adjusted by age, gender, age-gender interactions, major diagnostic category (MDC), all patient refined-diagnosis related group (APR-DRG) risk of mortality score, and transfers to the hospital. When reporting is by age, the adjustment is by gender, MDC, APR-DRG risk of mortality score, and transfers to the hospital; when reporting is by gender, the adjustment is by age, MDC, APR-DRG risk of mortality score, and transfers to the hospital. The AHRQ IQI software was modified to not use the present on admission (POA) indicators (or estimates of the likelihood of POA for secondary diagnosis).
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.
Measure Title
Adults with controlled hypertension
Measure Source
Healthy People 2020
Table Description
Geographic Representation
National
Years Available
1999-2010
Population Subgroups
Age, education, sex, income, ethnicity
Data Sources
Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health and Nutrition Examination Survey (NHANES).
Denominator
U.S. civilian noninstitutionalized population age 18 and over with high blood pressure/hypertension, excluding pregnant women
Numerator
Subset of denominator whose mean systolic blood pressure is less than 140 mm Hg and mean diastolic blood pressure is less than 90 mm Hg
Comments
Controlled hypertension is defined as having an average blood pressure reading of < 140/90 mm/Hg. Percentages are age adjusted to the 2000 U.S. standard population, except where indicated, using three age groups: 18-39, 40-59, and 60 and over. This measure is referred to as measure HDS-12 in Healthy People 2020 documentation.
Measure Title
Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high
Measure Source
Healthy People 2020
Table Description
Geographic Representation
National
Years Available
1998, 2003, 2008
Population Subgroups
Activity limitation, age, education, health insurance, income, race/ ethnicity, geographic location (residence)
Data Sources
Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).
Denominator
U.S. adult population age 18 and over
Numerator
Subset of the denominator who had their blood pressure measured in the last 2 years and can state whether their blood pressure was normal or high
Comments
This measure is referred to as measure HDS-4 in Healthy People 2020 documentation. Estimates are age adjusted to the 2000 U.S. standard population. Age data and health insurance data for the population age 65 and over are unadjusted.
Measure Title
Adults who received a blood cholesterol measurement in the last 5 years
Measure Source
Healthy People 2020
Table Description
Geographic Representation
National, States
Years Available
State: 1998, 2003, 2008
National: 1998, 2003, 2008
Population Subgroups
Activity limitation, age, education, health insurance, income, race/ ethnicity, geographic location (residence)
Data Sources
National
Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS)
State
CDC, Behavioral Risk Factor Surveillance System (BRFSS)
Denominator
U.S. adult population age 18 and over
Numerator
Subset of the denominator who have had their cholesterol checked within the previous 5 years
Comments
Data are age adjusted to the 2000 U.S. standard population. Age-adjusted rates are weighted sums of age-specific rates. This measure is referred to as measure HDS-6 in Healthy People 2020 documentation.
Page originally created July 2014
The information on this page is archived and provided for reference purposes only.
5600 Fishers Lane Rockville, MD 20857