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<div><div><ul><li><a href="/research/findings/nhqrdr/nhdr11/index.html">Main Page</a></li><li><a href="/research/findings/nhqrdr/nhdr11/ackno.html">Acknowledgments</a></li><li><a href="/research/findings/nhqrdr/nhdr11/key.html">Highlights From the National Healthcare Quality and Disparities Report</a></li><li><a href="/research/findings/nhqrdr/nhdr11/chap1.html">Chapter 1. Introduction and Methods</a></li><li><a href="nhdr11/chap2.htm">Chapter 2. Effectiveness</a></li><li><a href="/research/findings/nhqrdr/nhdr11/chap3.html">Chapter 3. Patient Safety</a></li><li><a href="/research/findings/nhqrdr/nhdr11/chap4.html">Chapter 4. Timeliness</a></li><li><a href="/research/findings/nhqrdr/nhdr11/chap5.html">Chapter 5. Patient Centeredness</a></li><li><a href="/research/findings/nhqrdr/nhdr11/chap6.html">Chapter 6. Care Coordination</a></li><li><a href="/research/findings/nhqrdr/nhdr11/chap7.html">Chapter 7. Efficiency</a></li><li><a href="/research/findings/nhqrdr/nhdr11/chap8.html">Chapter 8. Health Systems Infrastructure</a></li><li><a href="/research/findings/nhqrdr/nhdr11/chap9.html">Chapter 9. Access to Health Care</a></li><li><a href="/research/findings/nhqrdr/nhdr11/chap10.html">Chapter 10. Priority Populations</a></li><li><strong>Appendixes</strong></li><li>Data Sources</li><li>Detailed Methods</li><li>Measure Specifications</li><li>Data Tables</li></ul></div></div>
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<h1>Chapter 3. Patient Safety (Text Descriptions)</h1>
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<h2>National Healthcare Disparities Report, 2011</h2> <div id="basic-modal"><!-- start: Basic Modal -->
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<h4 class="figcaption">Figure 3.1. Adult surgery patients who received appropriate care, by gender and race/ethnicity, 2009</h4><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Gender</th><th scope="col">2009</th></tr><tr><td scope="row">Male</td><td align="center">85.2%</td></tr><tr><td scope="row">Female</td><td align="center">86.8%</td></tr></tbody></table><br /><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Race / Ethnicity</th><th scope="col">2009</th></tr><tr><td scope="row">White</td><td align="center">86.4%</td></tr><tr><td scope="row">African American</td><td align="center">85.8%</td></tr><tr><td scope="row">Hispanic</td><td align="center">84.5%</td></tr><tr><td scope="row">AI/AN</td><td align="center">82.0%</td></tr><tr><td scope="row">Asian</td><td align="center">84.2%</td></tr></tbody></table><p class="size2"><strong>Source:</strong> Centers for Medicare & Medicaid Services, Medicare Quality Improvement Organization Program, 2009.<br /><br /><strong>Denominator:</strong> Hospitalized patients having surgery.<br />2009 Achievable Benchmark: 91%.</p><p class="size2"><a href="/research/findings/nhqrdr/nhdr11/chap3.html#fig31">Return to Document</a></p><p><a id="fig32" name="fig32"> </a></p><h4 class="figcaption">Figure 3.2. Adult surgery patients who received appropriate timing of antibiotics: Overall composite, by race/ethnicity and gender, 2005-2009</h4><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Race / Ethnicity</th><th scope="col">2005</th><th scope="col">2006</th><th scope="col">2007</th><th scope="col">2008</th><th scope="col">2009</th></tr><tr><td scope="row">White</td><td align="center">75.2</td><td align="center">80.7</td><td align="center">86.8</td><td align="center">91.8</td><td align="center">94.9</td></tr><tr><td scope="row">Black</td><td align="center">75.2</td><td align="center">79.9</td><td align="center">85.8</td><td align="center">91.0</td><td align="center">94.3</td></tr><tr><td scope="row">Hispanic</td><td align="center">69.8</td><td align="center">74.7</td><td align="center">80.9</td><td align="center">86.8</td><td align="center">93.8</td></tr><tr><td scope="row">AI/AN</td><td align="center">77.4</td><td align="center">80.8</td><td align="center">85.2</td><td align="center">89.8</td><td align="center">93.1</td></tr><tr><td scope="row">Asian</td><td align="center">70.8</td><td align="center">78.0</td><td align="center">84.6</td><td align="center">90.6</td><td align="center">94.3</td></tr></tbody></table><br /><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Gender</th><th scope="col">2005</th><th scope="col">2006</th><th scope="col">2007</th><th scope="col">2008</th><th scope="col">2009</th></tr><tr><td scope="row">Total</td><td align="center">74.9</td><td align="center">80.3</td><td align="center">86.4</td><td align="center">91.4</td><td align="center">94.8</td></tr><tr><td scope="row">Male</td><td align="center">71.4</td><td align="center">78.6</td><td align="center">85.6</td><td align="center">91.0</td><td align="center">94.5</td></tr><tr><td scope="row">Female</td><td align="center">76.7</td><td align="center">81.2</td><td align="center">86.8</td><td align="center">91.6</td><td align="center">94.9</td></tr></tbody></table><p class="size2"><strong>Source:</strong> Centers for Medicare & Medicaid Services, Medicare Quality Improvement Organization Program, 2005-2009.<br /><br /><strong>Denominator:</strong> Hospitalized patients having surgery.<br /><br /><strong>Note:</strong> Populations not specifically noted as Hispanic are non-Hispanic.<br />2008 Achievable Benchmark: 95%.</p><p class="size2"><a href="/research/findings/nhqrdr/nhdr11/chap3.html#fig32">Return to Document</a></p><p><a id="fig33" name="fig33"> </a></p><h4 class="figcaption">Figure 3.3. Postoperative sepsis per 1,000 elective-surgery discharges with an operating room procedure, by race/ethnicity and insurance status, 2008</h4><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Race / Ethnicity</th><th scope="col">2008 (rate per 1,000)</th></tr><tr><td scope="row">White</td><td align="center">14.8</td></tr><tr><td scope="row">Black</td><td align="center">19.6</td></tr><tr><td scope="row">API</td><td align="center">14.7</td></tr><tr><td scope="row">Hispanic</td><td align="center">16.9</td></tr></tbody></table><br /><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Insurance Type</th><th scope="col">Rate per 1,000</th></tr><tr><td scope="row">Private Insurance</td><td align="center">13.8</td></tr><tr><td scope="row">Medicare</td><td align="center">16.2</td></tr><tr><td scope="row">Medicaid</td><td align="center">19.1</td></tr><tr><td scope="row">Uninsured/Self-Pay</td><td align="center">11.0</td></tr></tbody></table><p class="size2"><strong>Source:</strong> Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, State Inpatient Databases, disparities analysis file, 2007, and AHRQ Quality Indicators, modified version of 4.1.<br /><br /><strong>Denominator:</strong> All elective hospital surgical discharges, age 18 and over, with length of stay of 4 or more days, excluding patients admitted for infection, patients with cancer or immunocompromised states, patients with obstetric conditions, and admissions specifically for sepsis.<br /><br /><strong>Note:</strong> For this measure, lower rates are better.</p><p class="size2"><a href="/research/findings/nhqrdr/nhdr11/chap3.html#fig33">Return to Document</a></p><p><a id="fig34" name="fig34"> </a></p><h4 class="figcaption">Figure 3.4. Ambulatory medical care visits due to adverse effects of medical care per 1,000 people, by race and gender, 2006-2009</h4><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Race</th><th scope="col">2006 - 2007</th><th scope="col">2007-2008</th><th scope="col">2008-2009</th></tr><tr><td scope="row">White (rate per 1,000 people)</td><td align="center">37.0</td><td align="center">43.0</td><td align="center">33.6</td></tr><tr><td scope="row">Black (rate per 1,000 people)</td><td align="center">29.8</td><td align="center">42.2</td><td align="center">42.1</td></tr></tbody></table><br /><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Gender</th><th scope="col">2006-2007</th><th scope="col">2007-2008</th><th scope="col">2008-2009</th></tr><tr><td scope="row">Male (rate per 1,000 people)</td><td align="center">25.8</td><td align="center">32.8</td><td align="center">25.0</td></tr><tr><td scope="row">Female (rate per 1,000 people)</td><td align="center">43.1</td><td align="center">50.2</td><td align="center">41.0</td></tr></tbody></table><p class="size2"><strong>Source:</strong> Centers for Disease Control and Prevention, National Center for Health Statistics, National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 2007-2008.<br /><br /><strong>Denominator:</strong> U.S. Census Bureau estimated civilian noninstitutionalized population on July 1, 2007, and July 1, 2008.<br /><br /><strong>Note:</strong> For this measure, lower rates are better.</p><p class="size2"><a href="/research/findings/nhqrdr/nhdr11/chap3.html#fig34">Return to Document</a></p><p><a id="fig35" name="fig35"> </a></p><h4 class="figcaption">Figure 3.5. Composite: Mechanical adverse events associated with central venous catheter placement, by race and gender, 2005-2009</h4><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Race</th><th scope="col">2005</th><th scope="col">2006</th><th scope="col">2007</th><th scope="col">2009</th></tr><tr><td scope="row">White</td><td align="center">3.1</td><td align="center">4.3</td><td align="center">2.9</td><td align="center">3.2</td></tr><tr><td scope="row">Black</td><td align="center">3.8</td><td align="center">3.1</td><td align="center">3.2</td><td align="center">8.5</td></tr></tbody></table><br /><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Gender</th><th scope="col">2005</th><th scope="col">2006</th><th scope="col">2007</th><th scope="col">2009</th></tr><tr><td scope="row">Male</td><td align="center">3.6</td><td align="center">4.2</td><td align="center">2.8</td><td align="center">3.7</td></tr><tr><td scope="row">Female</td><td align="center">2.7</td><td align="center">4.0</td><td align="center">2.8</td><td align="center">4.1</td></tr></tbody></table><p class="size2"><strong>Source:</strong> Centers for Medicare & Medicaid Services, Medicare Patient Safety Monitoring System (MPSMS), 2005-2009.<br /><br /><strong>Denominator:</strong> Adult hospitalized Medicare fee-for-service discharges from the MPSMS sample with central venous catheter placement.<br /><br /><strong>Note:</strong> For this measure, lower rates are better.</p><p class="size2"><a href="/research/findings/nhqrdr/nhdr11/chap3.html#fig35">Return to Document</a></p><p><a id="fig36" name="fig36"> </a></p><h4 class="figcaption">Figure 3.6. Postoperative respiratory failure per 1,000 elective-surgery discharges after an operating room procedure, by race/ethnicity and income area, 2004-2008</h4><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Year</th><th scope="col">White</th><th scope="col">Black</th><th scope="col">API</th><th scope="col">Hispanic</th></tr><tr><td scope="row">2004 (rate postop. respiratory failure per 1,000 disch.)</td><td align="center">9.9</td><td align="center">13.4</td><td align="center">11.4</td><td align="center">11.7</td></tr><tr><td scope="row">2005 (rate postop. respiratory failure per 1,000 disch.)</td><td align="center">10.0</td><td align="center">12.9</td><td align="center">10.8</td><td align="center">11.5</td></tr><tr><td scope="row">2006 (rate postop. respiratory failure per 1,000 disch.)</td><td align="center">10.1</td><td align="center">12.6</td><td align="center">12.9</td><td align="center">12.3</td></tr><tr><td scope="row">2007 (rate postop. respiratory failure per 1,000 disch.)</td><td align="center">9.9</td><td align="center">12.0</td><td align="center">11.1</td><td align="center">10.9</td></tr><tr><td scope="row">2008 (rate postop. respiratory failure per 1,000 disch.)</td><td align="center">9.2</td><td align="center">11.2</td><td align="center">11.2</td><td align="center">10.8</td></tr></tbody></table><br /><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Year</th><th scope="col">First Quartile (Lowest)</th><th scope="col">Second Quartile</th><th scope="col">Third Quartile</th><th scope="col">Fourth Quartile (Highest)</th></tr><tr><td scope="row">2004 (rate postop. respiratory failure per 1,000 disch.)</td><td align="center">11.0</td><td align="center">10.7</td><td align="center">10.0</td><td align="center">9.0</td></tr><tr><td scope="row">2005 (rate postop. respiratory failure per 1,000 disch.)</td><td align="center">11.1</td><td align="center">10.2</td><td align="center">9.8</td><td align="center">8.9</td></tr><tr><td scope="row">2006 (rate postop. respiratory failure per 1,000 disch.)</td><td align="center">10.9</td><td align="center">10.4</td><td align="center">10.1</td><td align="center">9.1</td></tr><tr><td scope="row">2007 (rate postop. respiratory failure per 1,000 disch.)</td><td align="center">10.8</td><td align="center">10.2</td><td align="center">9.9</td><td align="center">8.7</td></tr><tr><td scope="row">2008 (rate postop. respiratory failure per 1,000 disch.)</td><td align="center">10.0</td><td align="center">9.4</td><td align="center">9.5</td><td align="center">8.8</td></tr></tbody></table><p class="size2"><strong>Source:</strong> Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, State Inpatient Databases, disparities analysis file, 2007, and AHRQ Quality Indicators, modified version of 4.1.<br /><br /><strong>Denominator:</strong> All elective hospital surgical discharges age 18 and over, excluding patients with respiratory disease, circulatory disease, neuromuscular disorders, obstetric conditions, selected surgeries for craniofascial anomalies, and secondary procedure of tracheostomy before or after surgery or as the only procedure.<br /><br /><strong>Note:</strong> For this measure, lower rates are better.</p><p class="size2"><a href="/research/findings/nhqrdr/nhdr11/chap3.html#fig36">Return to Document</a></p><p><a id="fig37" name="fig37"> </a></p><h4 class="figcaption">Figure 3.7. Deaths per 1,000 discharges with complications potentially resulting from care (failure to rescue), ages 18-89, by race/ethnicity and income area, 2004-2008</h4><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Race / Ethnicity</th><th scope="col">2004</th><th scope="col">2005</th><th scope="col">2006</th><th scope="col">2007</th><th scope="col">2008</th></tr><tr><td scope="row">White (rate of deaths per 1,000 discharges)</td><td align="center">135.8</td><td align="center">112.5</td><td align="center">106.2</td><td align="center">122.2</td><td align="center">120.5</td></tr><tr><td scope="row">Black (rate of deaths per 1,000 discharges)</td><td align="center">162.7</td><td align="center">128.8</td><td align="center">116.7</td><td align="center">132.6</td><td align="center">133.2</td></tr><tr><td scope="row">Asian (rate of deaths per 1,000 discharges)</td><td align="center">166.9</td><td align="center">142.1</td><td align="center">134.2</td><td align="center">137.8</td><td align="center">130.7</td></tr><tr><td scope="row">Hispanic (rate of deaths per 1,000 discharges)</td><td align="center">153.7</td><td align="center">128.6</td><td align="center">117.9</td><td align="center">138.0</td><td align="center">142.4</td></tr></tbody></table><br /><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Income Quartile</th><th scope="col">2004</th><th scope="col">2005</th><th scope="col">2006</th><th scope="col">2007</th><th scope="col">2008</th></tr><tr><td scope="row">First Quartile (Lowest) (rate of deaths per 1,000 discharges)</td><td align="center">147.5</td><td align="center">116.2</td><td align="center">106.9</td><td align="center">121.5</td><td align="center">127.2</td></tr><tr><td scope="row">Second Quartile (rate of deaths per 1,000 discharges)</td><td align="center">135.1</td><td align="center">113.7</td><td align="center">110.4</td><td align="center">125.4</td><td align="center">118.2</td></tr><tr><td scope="row">Third Quartile (rate of deaths per 1,000 discharges)</td><td align="center">137.9</td><td align="center">106.5</td><td align="center">105.7</td><td align="center">116.9</td><td align="center">123.4</td></tr><tr><td scope="row">Fourth Quartile (Highest) (rate of deaths per 1,000 discharges)</td><td align="center">129.9</td><td align="center">101.1</td><td align="center">99.9</td><td align="center">112.4</td><td align="center">120.4</td></tr></tbody></table><p class="size2"><strong>Source:</strong> Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, State Inpatient Databases, disparities analysis file, 2007, and AHRQ Quality Indicators, modified version of 4.1.<br /><br /><strong>Denominator:</strong> Patients ages 18-89 years from U.S. community hospitals whose hospitalizations are complicated by pneumonia, thromboembolic events, sepsis, acute renal failure, gastrointestinal bleeding or acute ulcer, shock, or cardiac arrest.<br /><br /><strong>Note:</strong> For this measure, lower rates are better.</p><p class="size2"><a href="/research/findings/nhqrdr/nhdr11/chap3.html#fig37">Return to Document</a></p><p><a id="fig38" name="fig38"> </a></p><h4 class="figcaption">Figure 3.8. Deaths per 1,000 hospital admissions with pneumonia as principal diagnosis, age 18 and over, by race/ethnicity and income area, 2004-2008</h4><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Race / Ethnicity</th><th scope="col">2004</th><th scope="col">2005</th><th scope="col">2007</th><th scope="col">2008</th></tr><tr><td scope="row">White (rate of deaths per 1,000)</td><td align="center">54.7</td><td align="center">49.7</td><td align="center">40.9</td><td align="center">36.4</td></tr><tr><td scope="row">Black (rate of deaths per 1,000)</td><td align="center">49.7</td><td align="center">43.2</td><td align="center">34.7</td><td align="center">32.4</td></tr><tr><td scope="row">API (rate of deaths per 1,000)</td><td align="center">57.8</td><td align="center">51.6</td><td align="center">42.8</td><td align="center">37.2</td></tr><tr><td scope="row">Hispanic (rate of deaths per 1,000)</td><td align="center">46.9</td><td align="center">42.3</td><td align="center">35.2</td><td align="center">31.3</td></tr></tbody></table><br /><table border="1" cellpadding="3" width="80%"><tbody><tr><th scope="col">Income Quartile</th><th scope="col">2004</th><th scope="col">2005</th><th scope="col">2006</th><th scope="col">2007</th><th scope="col">2008</th></tr><tr><td scope="row">First Quartile (Lowest) (rate of deaths per 1,000)</td><td align="center">56.0</td><td align="center">49.7</td><td align="center">46.1</td><td align="center">41.9</td><td align="center">38.5</td></tr><tr><td scope="row">Second Quartile (rate of deaths per 1,000)</td><td align="center">53.4</td><td align="center">49.2</td><td align="center">45.8</td><td align="center">39.7</td><td align="center">35.8</td></tr><tr><td scope="row">Third Quartile (rate of deaths per 1,000)</td><td align="center">52.8</td><td align="center">45.7</td><td align="center">40.4</td><td align="center">37.9</td><td align="center">33.2</td></tr><tr><td scope="row">Fourth Quartile (Highest) (rate of deaths per 1,000)</td><td align="center">51.7</td><td align="center">46.6</td><td align="center">42.1</td><td align="center">38.2</td><td align="center">33.2</td></tr></tbody></table><p class="size2"><strong>Source:</strong> Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, State Inpatient Databases, disparities analysis file, 2007, and AHRQ Quality Indicators, modified version of 4.1.<br /><br /><strong>Denominator:</strong> All discharges age 18 and over with principal diagnosis code of pneumonia, excluding patients transferred to another short-term hospital and obstetric and neonatal admissions.<br /><br /><strong>Note:</strong> For this measure, lower rates are better.<br />2007 Achievable Benchmark: 28.</p><p class="size2"><a href="/research/findings/nhqrdr/nhdr11/chap3.html#fig38">Return to Document</a></p> </div>
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<div class="current-as-of">Page last reviewed October 2014</div>
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<div class="citation">
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<span>Internet Citation: Chapter 3. Patient Safety (Text Descriptions): National Healthcare Disparities Report, 2011.
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October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/research/findings/nhqrdr/nhdr11/chap3txt.html</span>
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