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

Measures

Potentially avoidable hospitalizations for all conditions
Potentially avoidable hospitalizations for acute conditions
Potentially avoidable hospitalizations for chronic conditions
Potentially avoidable hospitalizations and emergency department encounters for congestive heart failure (CHF)
Perforated appendixes per 1,000 admissions with appendicitis
 

Measure Title

Potentially avoidable hospitalizations for all conditions

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

State: 2004, 2007, 2008, 2009

National: 2000-2010

Population Subgroups

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

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 who qualified to be in the Numerator for any of the following PQI measures:

• PQI 1: Diabetes, short-term complications.
• PQI 3: Diabetes, long-term complications.
• PQI 5: Chronic obstructive pulmonary disease.
• PQI 7: Hypertension.
• PQI 8: Congestive heart failure.
• PQI 10: Dehydration.
• PQI 11: Bacterial pneumonia.
• PQI 12: Urinary tract infections.
• PQI 13: Angina without procedure.
• PQI 14: Uncontrolled diabetes.
• PQI 15: Asthma in younger adults.
• PQI 16: Lower extremity amputations among patients with diabetes.

Comments

This measure is based on the 11 AHRQ PQIs for angina, asthma, bacterial pneumonia, congestive heart failure, dehydration, diabetes, hypertension, and urinary tract infection.

For consistency of longitudinal reporting, the modified overall composite does not include AHRQ PQI 5 for chronic obstructive pulmonary disease because it is affected by International Classification of Diseases, Ninth Revision coding changes.

Rates are adjusted by age and gender using the total 2000 U.S. standard population.

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

Potentially avoidable hospitalizations for acute conditions

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

State 2000, 2004, 2007, 2008, 2009

National: 2000-2010

Population Subgroups

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

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. civilian population age 18 and over

Numerator

Subset of the denominator who qualified for any individual PQI acute care Numerator (PQI 10, PQI 11, and PQI 12

Comments

This measure is based on the three AHRQ PQIs for dehydration, bacterial pneumonia, and urinary tract infection.

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

Potentially avoidable hospitalizations for chronic conditions

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

State: 2000, 2004, 2007, 2008, 2009

National: 2000-2010

Population Subgroups

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

Data Source

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. civilian population age 18 and over

Numerator

Subset of the denominator who qualified for any individual PQI Numerator considered chronic (PQI 1, PQI 3, PQI 7, PQI 8, and PQI 13-16) (see Comments)

Comments

This measure is based on the eight AHRQ PQIs for angina, asthma, congestive heart failure, diabetes, and hypertension. For consistency of longitudinal reporting, the modified overall composite does not include AHRQ PQI 5 for chronic obstructive pulmonary disease because it is affected by International Classification of Diseases, Ninth Revision coding changes.

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

Potentially avoidable hospitalizations and emergency department encounters for 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), Prevention Quality Indicators (PQIs)

Table Description

Geographic Representation

National

Years Available

2008-2010

Population Subgroups

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

Data Source

AHRQ, CDOM, HCUP, Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS)

Denominator

U.S. civilian population age 18 and over

Numerator

Subset of the denominator admitted to a hospital or visited an emergency department for CHF

Comments

Consistent with the AHRQ PQI software, CHF must be the principal diagnosis and the following are excluded: admissions with cardiac procedures and transfers from other institutions.

Rates are adjusted by age and gender using the total 2000 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.

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Measure Title

Perforated appendixes per 1,000 admissions with appendicitis

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

State: 2000, 2004, 2007, 2008, 2009, 2010

National: 2000-2010

Indian Health Service: 2003-2011

Population Subgroups

Age, bed size (hospital), gender, health insurance, geographic location (hospital and residence), income, ownership of hospital, region, teaching status of hospital, persons served by the Indian Health Service (IHS)

Data Source

National

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

State

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

Other

Indian Health Service (IHS), Office of Information Technology/National Patient Information Reporting System (NPIRS), National Data Warehouse (NDW), Workload and Population Data Mart

Denominator

Nonmaternal discharges with principal or secondary diagnosis of appendicitis, excluding transfers from other institutions.

Numerator

Subset of the denominator with principal or secondary diagnosis code for perforation or abscess of appendix

Comments

Consistent with the AHRQ PQI software, transfers from other institutions are excluded.

Rates are adjusted by age and gender using U.S. hospitalizations 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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