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<h1>Efficiency</h1>
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<h3>2010 National Healthcare Quality and Disparities Reports</h3>
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<div class="page-description"><span>The National Healthcare Quality Report (NHQR) is a comprehensive national overview of quality of health care in the United States. It is organized around four dimensions of quality of care: effectiveness, patient safety, timeliness, and patient centeredness.</span></div>
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<a id="efficiency" name="efficiency"></a> <p><a href="#pot1"><strong>Potentially Avoidable Hospitalizations and Cost</strong></a><br /><a href="#potmt1">Potentially avoidable hospitalizations for acute, chronic, and all conditions</a><br /><a href="#potmt2">Potentially avoidable hospitalizations</a><br /><a href="#potmt3">Potentially avoidable hospitalizations for acute conditions</a><br /><a href="#potmt4">Potentially avoidable hospitalizations for chronic conditions</a><br /><a href="#potmt5">Potentially avoidable hospitalizations for all conditions, by State</a><br /><a href="#potmt6">Potentially avoidable hospitalizations for acute conditions, by State</a><br /><a href="#potmt7">Potentially avoidable hospitalizations for chronic conditions, by State</a><br /><br /><a href="#potem1"><strong>Potentially Avoidable Emergency Encounters</strong></a><br /><a href="#potemtm1">Potentially avoidable emergency department encounters for adults with asthma</a><br /><a href="#potemtm2">Potentially avoidable emergency department encounters for children with asthma</a><br /><br /><a href="#red1"><strong>Reduction of Unnecessary Costs</strong></a><br /><a href="#redmt1">Ambulatory medical care visits where antibiotics were prescribed for a diagnosis of a common cold</a><br /><a href="#redmt2">Doctor's office, emergency department, and outpatient department visits where antibiotics were prescribed for a diagnosis of a common cold</a><br /> </p><hr /> <a id="pot1" name="pot1"></a> <h2>Potentially Avoidable Hospitalizations</h2> <a id="potmt1" name="potmt1"></a> <h3>Measure Title</h3><p>Potentially avoidable hospitalizations for acute, chronic, and all conditions.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, version 3.1.</p><h3>National Tables</h3><p>15_1_1.1 Potentially avoidable hospitalizations per 100,000 population for all conditions, age 18 and over, United States, 2000, 2004-2007</p><p>15_1_1.2 Potentially avoidable hospitalizations per 100,000 population for acute conditions, age 18 and over, United States, 2000, 2004-2007</p><p>15_1_1.3 Potentially avoidable hospitalizations per 100,000 population for chronic conditions, age 18 and over, United States, 2000, 2004-2007</p><h3>National Data Source</h3><p>AHRQ, CDOM, HCUP, NIS, AHRQ Quality Indicators, version 3.1.</p><h3>National Denominator</h3><p>U.S. population age 18 and over.</p><h3>National Numerator</h3><p>Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator: 1, 3, 5, 7, 8, 10, 11, 12, 13, 14, 15, and 16 (Table 15_1_1).</p><p>Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator considered acute: 10, 11, and 12 (Table 15_1_2).</p><p>Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator considered chronic: 1, 3, 5, 7, 8, 13, 14, 15, and 16 (Table 15_1_3).</p><p>PQI components of the composites include:</p><ul><li style=" list-style: none;">.</li><li>PQI 1: Diabetes, short-term complications.</li><li>PQI 3: Diabetes, long-term complications.</li><li>PQI 5: Chronic obstructive pulmonary disease.</li><li>PQI 7: Hypertension.</li><li>PQI 8: Congestive heart failure.</li><li>PQI 10: Dehydration.</li><li>PQI 11: Bacterial pneumonia.</li><li>PQI 12: Urinary infections.</li><li>PQI 13: Angina without procedure.</li><li>PQI 14: Uncontrolled diabetes.</li><li>PQI 15: Adult asthma.</li><li>PQI 16: Lower extremity amputations among patients with diabetes.</li></ul><h3>Comments</h3><p>Rates are adjusted by age and gender using the total 2000 U.S. standard population.</p><p>This table was created using version 3.1 of the AHRQ PQI software. For additional information, refer to <a href="http://www.qualityindicators.ahrq.gov/">http://www.qualityindicators.ahrq.gov/</a>.</p><p class="size2"><a href="#efficiency">Top of Page</a></p><hr /> <a id="potmt2" name="potmt2"></a> <h2>Potentially Avoidable Hospitalizations</h2><h3>Measure Title</h3><p>Potentially avoidable hospitalizations.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file, 2007, and AHRQ Quality Indicators, version 3.1.</p><h3>National Table</h3><p>15_1_1.4 Potentially avoidable hospitalizations per 100,000 population for all conditions, age 18 and over, United States, 2007, by:</p><ul><li>Race/ethnicity.</li></ul><h3>National Data Source</h3><p>AHRQ, CDOM, HCUP, SID, AHRQ Quality Indicators, version 3.1.</p><h3>Denominator</h3><p>U.S. civilian population age 18 and over.</p><h3>Numerator</h3><p>Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for all conditions.</p><p>Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator: 1, 3, 5, 7, 8, 10, 11, 12, 13, 14, 15, and 16.</p><p>PQI components of the composite include:</p><ul><li>PQI 1: Diabetes, short-term complications.</li><li>PQI 3: Diabetes, long-term complications.</li><li>PQI 5: Chronic obstructive pulmonary disease.</li><li>PQI 7: Hypertension.</li><li>PQI 8: Congestive heart failure.</li><li>PQI 10: Dehydration.</li><li>PQI 11: Bacterial pneumonia.</li><li>PQI 12: Urinary infections.</li><li>PQI 13: Angina without procedure.</li><li>PQI 14: Uncontrolled diabetes.</li><li>PQI 15: Adult asthma.</li><li>PQI 16: Lower extremity amputations among patients with diabetes.</li></ul><h3>Comments</h3><p>The SID disparities analysis file, created specifically for the NHQR/NHDR to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 26 States that participate in HCUP and have high-quality race/ethnicity data: AR, AZ, CA, CO, CT, FL, GA, HI, KS, MA, MD, MI, MO, NH, NJ, NY, OK, RI, SC, TN, TX, UT, VA, VT, WI, and WY.</p><p class="size2"><a href="#efficiency">Top of Page</a></p><hr /> <a id="potmt3" name="potmt3"></a> <h2>Potentially Avoidable Hospitalizations</h2><h3>Measure Title</h3><p>Potentially avoidable hospitalizations for acute conditions.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file, 2007, and AHRQ Quality Indicators, version 3.1.</p><h3>National Table</h3><p>15_1_1.5 Potentially avoidable hospitalizations per 100,000 population for acute conditions, age 18 and over, United States, 2007, by:</p><ul><li>Race/ethnicity.</li></ul><h3>National Data Source</h3><p>AHRQ, CDOM, HCUP, SID AHRQ Quality Indicators, version 3.1.</p><h3>National Denominator</h3><p>U.S. civilian population age 18 and over.</p><h3>National Numerator</h3><p>Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for acute conditions.</p><p>Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator considered acute: 10, 11, and 12.</p><p>PQI components of the composite include:</p><ul><li>PQI 10: Dehydration.</li><li>PQI 11: Bacterial pneumonia.</li><li>PQI 12: Urinary infections.</li></ul><h3>Comments</h3><p>The SID disparities analysis file, created specifically for the NHQR/NHDR to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 26 States that participate in HCUP and have high-quality race/ethnicity data: AR, AZ, CA, CO, CT, FL, GA, HI, KS, MA, MD, MI, MO, NH, NJ, NY, OK, RI, SC, TN, TX, UT, VA, VT, WI, and WY.</p><p class="size2"><a href="#efficiency">Top of Page</a></p><hr /> <a id="potmt4" name="potmt4"></a> <h2>Potentially Avoidable Hospitalizations</h2><h3>Measure Title</h3><p>Potentially avoidable hospitalizations for chronic conditions.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file, 2007, and AHRQ Quality Indicators, version 3.1.</p><h3>National Table</h3><p>15_1_1.6 Potentially avoidable hospitalizations per 100,000 population for chronic conditions, age 18 and over, United States, 2007 by:</p><ul><li>Race/ethnicity.</li></ul><h3>National Data Source</h3><p>AHRQ, CDOM, HCUP, SID, AHRQ Quality Indicators, version 3.1.</p><h3>National Denominator</h3><p>U.S. civilian population age 18 and over.</p><h3>National Numerator</h3><p>Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for chronic conditions.</p><p>Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator considered chronic: 1, 3, 5, 7, 8, 13, 14, 15, and 16.</p><p>PQI components of the composite include:</p><ul><li>PQI 1: Diabetes, short-term complications.</li><li>PQI 3: Diabetes, long-term complications.</li><li>PQI 5: Chronic obstructive pulmonary disease.</li><li>PQI 7: Hypertension.</li><li>PQI 8: Congestive heart failure.</li><li>PQI 13: Angina without procedure.</li><li>PQI 14: Uncontrolled diabetes.</li><li>PQI 15: Adult asthma.</li><li>PQI 16: Lower extremity amputations among patients with diabetes.</li></ul><h3>Comments</h3><p>The SID disparities analysis file, created specifically for the NHQR/NHDR to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 26 States that participate in HCUP and have high-quality race/ethnicity data: AR, AZ, CA, CO, CT, FL, GA, HI, KS, MA, MD, MI, MO, NH, NJ, NY, OK, RI, SC, TN, TX, UT, VA, VT, WI, and WY.</p><p class="size2"><a href="#efficiency">Top of Page</a></p><hr /> <a id="potmt5" name="potmt5"></a> <h2>Potentially Avoidable Hospitalizations</h2><h3>Measure Title</h3><p>Potentially avoidable hospitalizations for all conditions, by State.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, version 3.1.</p><h3>State Table</h3><p>15_1_1.7 Potentially avoidable hospitalizations per 100,000 population for all conditions, age 18 and over, by State, 2006-2007</p><h3>State Data Source</h3><p>AHRQ, CDOM, HCUP, SID, AHRQ Quality Indicators, version 3.1.</p><h3>State Denominator</h3><p>U.S. civilian population age 18 and over.</p><h3>State Numerator</h3><p>Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for all conditions.</p><p>PQI components of the composite include:</p><ul><li>PQI 1: Diabetes, short-term complications.</li><li>PQI 3: Diabetes, long-term complications.</li><li>PQI 5: Chronic obstructive pulmonary disease.</li><li>PQI 7: Hypertension.</li><li>PQI 8: Congestive heart failure.</li><li>PQI 10: Dehydration.</li><li>PQI 11: Bacterial pneumonia.</li><li>PQI 12: Urinary infections.</li><li>PQI 13: Angina without procedure.</li><li>PQI 14: Uncontrolled diabetes.</li><li>PQI 15: Adult asthma.</li><li>PQI 16: Lower extremity amputations among patients with diabetes.</li></ul><h3>Comments</h3><p>State estimates are from the State Inpatient Databases (SID). Not all States participate in HCUP.</p><p class="size2"><a href="#efficiency">Top of Page</a></p><hr /> <a id="potmt6" name="potmt6"></a> <h2>Potentially Avoidable Hospitalizations</h2><h3>Measure Title</h3><p>Potentially avoidable hospitalizations for acute conditions, by State.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, version 3.1.</p><h3>State Table</h3><p>15_1_1.8 Potentially avoidable hospitalizations per 100,000 population for acute conditions, age 18 and over, by State, 2006-2007</p><h3>State Data Source</h3><p>AHRQ, CDOM, HCUP, NIS. AHRQ Quality Indicators, version 3.1.</p><h3>State Denominator</h3><p>U.S. civilian population age 18 and over.</p><h3>State Numerator</h3><p>Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for acute conditions.</p><p>PQI components of the composite include:</p><ul><li>PQI 10: Dehydration.</li><li>PQI 11: Bacterial pneumonia.</li><li>PQI 12: Urinary infections.</li></ul><h3>Comments</h3><p>State estimates are from the State Inpatient Databases (SID). Not all States participate in HCUP.</p><p class="size2"><a href="#efficiency">Top of Page</a></p><hr /> <a id="potmt7" name="potmt7"></a> <h2>Potentially Avoidable Hospitalizations</h2><h3>Measure Title</h3><p>Potentially avoidable hospitalizations for chronic conditions, by State.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, version 3.1.</p><h3>State Table</h3><p>15_1_1.9 Potentially avoidable hospitalizations per 100,000 population for chronic conditions, age 18 and over, by State, 2006-2007</p><h3>State Data Source</h3><p>AHRQ, CDOM, HCUP, NIS and AHRQ Quality Indicators, version 3.1.</p><h3>State Denominator</h3><p>U.S. civilian population age 18 and over.</p><h3>State Numerator</h3><p>Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for chronic conditions.</p><p>PQI components of the composite include:</p><ul><li>PQI 1: Diabetes, short-term complications.</li><li>PQI 3: Diabetes, long-term complications.</li><li>PQI 5: Chronic obstructive pulmonary disease.</li><li>PQI 7: Hypertension.</li><li>PQI 8: Congestive heart failure.</li><li>PQI 13: Angina without procedure.</li><li>PQI 14: Uncontrolled diabetes.</li><li>PQI 15: Adult asthma.</li><li>PQI 16: Lower extremity amputations among patients with diabetes.</li></ul><h3>Comments</h3><p>State estimates are from the State Inpatient Databases (SID). Not all States participate in HCUP.</p><p class="size2"><a href="#efficiency">Top of Page</a></p><hr /> <a id="potem1" name="potem1"></a> <h2>Potentially Avoidable Emergency Encounters</h2> <a id="potemtm1" name="potemtm1"></a> <h3>Measure Title</h3><p>Potentially avoidable emergency department encounters for adults with asthma.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS), 2007, and AHRQ Quality Indicators, version 3.1.</p><h3>National Table</h3><p>15_1_6.1 Emergency department visits for asthma per 100,000 population, age 18 and over, United States, 2007</p><h3>National Data Source</h3><p>AHRQ, CDOM, HCUP, NIS, NEDS, AHRQ Quality Indicators, version 3.1.</p><h3>National Denominator</h3><p>U.S. civilian population age 18 and over.</p><h3>National Numerator</h3><p>Subset of denominator with an emergency department asthma visit.</p><h3>Comment</h3><p>For additional information on AHRQ Quality Indicators refer to <a href="http://www.qualityindicators.ahrq.gov/">http://www.qualityindicators.ahrq.gov/</a>.</p><p class="size2"><a href="#efficiency">Top of Page</a></p><hr /> <a id="potemtm2" name="potemtm2"></a> <h2>Potentially Avoidable Emergency Encounters</h2><h3>Measure Title</h3><p>Potentially avoidable emergency department encounters for children with asthma.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS), 2007, and AHRQ Quality Indicators, version 3.1.</p><h3>National Table</h3><p>15_1_6.2 Emergency department visits per 100,000 population, ages 2-17, United States, 2007</p><h3>National Data Source</h3><p>AHRQ, CDOM, HCUP, NIS, NEDS, AHRQ Quality Indicators, version 3.1.</p><h3>National Denominator</h3><p>U.S. civilian population ages 2-17.</p><h3>National Numerator</h3><p>Subset of denominator with an emergency department asthma visit.</p><h3>Comment</h3><p>For additional information on AHRQ Quality Indicators refer to <a href="http://www.qualityindicators.ahrq.gov/">http://www.qualityindicators.ahrq.gov/</a>.</p><p class="size2"><a href="#efficiency">Top of Page</a></p><hr /> <a id="red1" name="red1"></a> <h2>Reduction of Unnecessary Costs</h2> <a id="redmt1" name="redmt1"></a> <h3>Measure Title</h3><p>Ambulatory medical care visits where antibiotics were prescribed for a diagnosis of common cold.</p><h3>Measure Source</h3><p>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).</p><h3>National Table</h3><p>15_2_1.1 Antibiotic prescribing at ambulatory medical care visits for colds per 10,000 population, United States, 2005-2008</p><h3>National Data Source</h3><p>CDC, NCHS, NAMCS, NHAMCS.</p><h3>National Denominator</h3><p>U.S. civilian noninstitutionalized population.</p><h3>National Numerator</h3><p>Subset of denominator with a diagnosis of a common cold who received an antibiotic prescription during an ambulatory medical care visit.</p><p class="size2"><a href="#efficiency">Top of Page</a></p><hr /> <a id="redmt2" name="redmt2"></a> <h2>Reduction of Unnecessary Costs</h2><h3>Measure Title</h3><p>Doctor's office, emergency department, and outpatient department visits where antibiotics were prescribed for a diagnosis of a common cold.</p><h3>Measure Source</h3><p>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).</p><h3>National Tables</h3><p>15_2_1.2 Doctor's office, emergency department, and outpatient department visits where antibiotics were prescribed for a diagnosis of a common cold, per 10,000 population, United States, 1997-2007</p><p>15_2_1.3a Doctor's office, emergency department, and outpatient department visits where antibiotics were prescribed for a diagnosis of common cold per 10,000 population, United States, 2007-2008, by:</p><ul><li>Race.</li></ul><h3>National Data Source</h3><p>CDC, NCHS, NAMCS, NHAMCS.</p><h3>National Denominator</h3><p>U.S. civilian noninstitutionalized population.</p><h3>National Numerator</h3><p>Subset of the denominator diagnosed with the common cold (ICD-9-CM codes 460.0, 465, or 472.0) for whom an antibiotic course was ordered, supplied, administered, or continued.</p><h3>Comments</h3><p>This measure is referred to as measure 14-19 in Healthy People 2010 documentation.</p><p class="size2"><a href="#efficiency">Top of Page</a><br /><a href="/research/findings/nhqrdr/nhqrdr10/index.html">Return to Measure Specifications</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: Efficiency: 2010 National Healthcare Quality and Disparities Reports.
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October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/research/findings/nhqrdr/nhqrdr10/measurespec/efficiency.html</span>
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