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<h1>Timeliness</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="time" name="time"></a> <p><a href="#gapc1"><strong>Getting Appointments for Care</strong></a><br /><a href="#gapcmt1">Adults who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted</a><br /><a href="#gapcmt2">Adults with Medicare or Medicaid who had an appointment for routine health care in the last 12 months who always got appointments for routine care as soon as wanted</a><br /><a href="#gapcmt3">Children who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted</a><br /><a href="#gapcmt4">Children who had an appointment for routine health care in the last 6 months who always got appointments for routine care as soon as wanted</a><br /><a href="#gapcmt5">Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted</a><br /><a href="#gapcmt6">Adults with Medicare or Medicaid who needed care right away for an illness, injury, or condition in the last 12 months who always got care as soon as wanted</a><br /><a href="#gapcmt7">Children who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted</a><br /><a href="#gapcmt8">Children who needed care right away for an illness, injury, or condition in the last 6 months who always got care as soon as wanted</a><br /><br /><a href="#wtim1"><strong>Waiting Time</strong></a><br /><a href="#wtimmt1">Emergency department (ED) visits lasting 6 or more hours and resulting in admission to the hospital or transfer to another facility, per 1,000 ED visits</a><br /><a href="#wtimmt2">ED visits where patients left without being seen</a><br /><a href="#wtimmt3">Hospital patients with heart attack who received percutaneous coronary intervention (PCI) within 90 minutes of arrival</a><br /><a href="#wtimmt4">Hospital patients with heart attack who received fibrinolytic medication within 30 minutes of arrival</a><br /> </p><hr /> <a id="gapc1" name="gapc1"></a> <h2>Getting Appointments for Care</h2> <a id="gapcmt1" name="gapcmt1"></a> <h3>Measure Title</h3><p>Adults who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).</p><h3>National Tables</h3><p>13_1_1.1 Adults who had an appointment for routine health care in the last 12 months who sometimes or never got appointments as soon as wanted, United States, 2002-2007</p><p>13_1_1.2a-d Adults who made an appointment for routine health care in the last 12 months who sometimes or never got an appointment as soon as wanted, United States, 2007 by:</p><ul><li>Race.</li><li>Ethnicity.</li><li>Family Income.</li><li>Education.</li></ul><h3>National Data Source</h3><p>AHRQ, CFACT, MEPS.</p><h3>National Denominator</h3><p>Adults age 18 and over who made an appointment for regular or routine health care in the past 12 months and had a valid response to the MEPS question, "In the last 12 months, how often did you get an appointment for regular or routine health care as soon as you wanted?"</p><h3>National Numerator</h3><p>Subset of the denominator who answered "sometimes" or "never" to the question in the denominator.</p><h3>Comments</h3><p>National Tables report data from the MEPS Self-Administered Questionnaire (SAQ). See the MEPS entry in the Data Sources appendix for more information on the SAQ.</p><p class="size2"><a href="#time">Top of Page</a></p><hr /> <a id="gapcmt2" name="gapcmt2"></a> <h2>Getting Appointments for Care</h2><h3>Measure Title</h3><p>Adults with Medicare or Medicaid who had an appointment for routine health care in the last 12 months who always got appointments for routine care as soon as wanted.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Quality Improvement and Patient Safety (CQUIPS), National CAHPS® Benchmarking Database.</p><h3>State Tables</h3><p>13_1_1.3 Adults who had an appointment for routine health care in the last 12 months who always got appointments for routine care as soon as wanted, Medicare fee for service, by State, 2007-2009</p><p>13_1_1.4 Adults who had an appointment for routine health care in the last 12 months who always got appointments for routine care as soon as wanted, Medicare managed care, by State, 2007-2009</p><p>13_1_1.5 Adults who had an appointment for routine health care in the last 6 months who always got appointments for routine care as soon as wanted, Medicaid, by State, 2007-2009</p><h3>State Data Source</h3><p>AHRQ, CQUIPS, CAHPS.</p><h3>State Denominator</h3><p>Adults age 18 and over who made an appointment for regular or routine health care in the past 12 months and had a valid response to the MEPS question, "In the last 12 months [6 months for Medicaid], how often did you get an appointment for regular or routine health care as soon as you wanted?"</p><h3>State Numerator</h3><p>Subset of the denominator who answered the above question "always."</p><p class="size2"><a href="#time">Top of Page</a></p><hr /> <a id="gapcmt3" name="gapcmt3"></a> <h2>Getting Appointments for Care</h2><h3>Measure Title</h3><p>Children who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).</p><h3>National Tables</h3><p>13_1_2.1 Children who had an appointment for routine health care in the last 12 months who sometimes or never got appointments as soon as wanted, United States, 2002-2007</p><p>13_1_2.2a-c Children who had an appointment for routine health care in the last 12 months who sometimes or never got an appointment for routine care as soon as wanted, United States, 2007 by:</p><ul><li>Race.</li><li>Ethnicity.</li><li>Family Income.</li></ul><h3>National Data Source</h3><p>AHRQ, CFACT, MEPS.</p><h3>National Denominator</h3><p>Children who had an appointment for regular or routine health care in the past 12 months and with a valid response to the question, "In the last 12 months, how often did [the person] get an appointment for regular or routine health care as soon as you wanted?"</p><h3>National Numerator</h3><p>Subset of the denominator who, according to their parents or guardians, answered the above question "sometimes" or "never."</p><p class="size2"><a href="#time">Top of Page</a></p><hr /> <a id="gapcmt4" name="gapcmt4"></a> <h2>Getting Appointments for Care</h2><h3>Measure Title</h3><p>Children who had an appointment for routine health care in the last 6 months who always got appointments for routine care as soon as wanted.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ) , Center for Quality Improvement and Patient Safety (CQUIPS), National CAHPS Benchmarking Database.</p><h3>State Table</h3><p>13_1_2.3 Children who had an appointment for routine health care in the last 6 months who always got appointments for routine care as soon as wanted, Medicaid, by State, 2007-2009</p><h3>State Data Source</h3><p>AHRQ, CQUIPS, CAHPS.</p><h3>State Denominator</h3><p>Medicaid and State Children's Health Insurance Plans (SCHIP) enrollees.</p><h3>State Numerator</h3><p>Subset of the denominator who, according to their parents or guardians, answered the above question "always."</p><h3>Comments</h3><p>The National Table reports data from the MEPS Child Health section. See the MEPS entry in the Data Sources appendix for more information Nonrespondents, as well as "don't know" responses, were excluded.</p><p class="size2"><a href="#time">Top of Page</a></p><hr /> <a id="gapcmt5" name="gapcmt5"></a> <h2>Getting Appointments for Care</h2><h3>Measure Title</h3><p>Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).</p><h3>National Tables</h3><p>13_1_3.1 Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, United States, 2002-2007</p><p>13_1_3.2a-d Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, United States, 2007, by:</p><ul><li>Race.</li><li>Ethnicity.</li><li>Family Income.</li><li>Education.</li></ul><h3>National Data Source</h3><p>AHRQ, CFACT, MEPS.</p><h3>National Denominator</h3><p>Adults age 18 and over who in the past 12 months had an illness or injury that needed care right away and had a valid response to the question: "In the last 12 months, when you needed care right away for an illness or injury, how often did you get care as soon as you wanted?"</p><h3>National Numerator</h3><p>Subset of the denominator who responded "sometimes" or "never" to the above question.</p><h3>Comments</h3><p>National Tables report data from the MEPS Self-Administered Questionnaire (SAQ). See the MEPS entry in the Data Sources appendix for more information on the SAQ.</p><p>Nonrespondents, as well as "don't know" responses, were excluded.</p><p class="size2"><a href="#time">Top of Page</a></p><hr /> <a id="gapcmt6" name="gapcmt6"></a> <h2>Getting Appointments for Care</h2><h3>Measure Title</h3><p>Adults with Medicare or Medicaid who needed care right away for an illness, injury, or condition in the last 12 months who always got care as soon as wanted.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Quality Improvement and Patient Safety (CQUIPS), National Consumer Assessment of Healthcare Providers and Systems (CAHPS) Benchmarking Database.</p><h3>State Tables</h3><p>13_1_3.3 Adults who needed care right away for an illness, injury, or condition in the last 12 months who always got care as soon as wanted, Medicare fee for service, by State, 2007-2009</p><p>13_1_3.4 Adults who needed care right away for an illness, injury, or condition in the last 12 months who always got care as soon as wanted, Medicare managed care, by State, 2007-2009</p><p>13_1_3.5 Adults who needed care right away for an illness, injury, or condition in the last 6 months who always got care as soon as wanted, Medicaid, by State, 2007-2009</p><h3>State Data Source</h3><p>AHRQ, CQUIPS, CAHPS.</p><h3>State Denominator</h3><p>For Medicaid, adults who reported having an illness, injury, or condition who needed care right away in a clinic, emergency room, or doctor's office in the last 6 months.</p><p>For Medicare managed care and Medicare fee for service, adults who reported having an illness, injury, or condition who needed care right away in a clinic, emergency room, or doctor's office in the last 12 months.</p><h3>State Numerator</h3><p>For Medicaid, subset of the denominator who answered "Always" to the question, "In the last 6 months, when you needed care right away for an illness, injury, or condition, how often did you get care as soon as you wanted?"</p><p>For Medicare managed care and Medicare fee for service, subset of the denominator who answered "Always" to the question, "In the last 12 months, when you needed care right away for an illness, injury, or condition, how often did you get care as soon as you wanted?"</p><p class="size2"><a href="#time">Top of Page</a></p><hr /> <a id="gapcmt7" name="gapcmt7"></a> <h2>Getting Appointments for Care</h2><h3>Measure Title</h3><p>Children who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).</p><h3>National Tables</h3><p>13_1_4.1 Children who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, United States, 2002-2007</p><p>13_1_4.2a-c Children who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, United States, 2007, by:</p><ul><li>Race.</li><li>Ethnicity.</li><li>Family Income.</li></ul><h3>National Data Source</h3><p>AHRQ, CFACT, MEPS.</p><h3>National Denominator</h3><p>Children under age 18 who had an illness or injury that needed care right away in the past 12 months, with a valid response to the question "In the last 12 months, when [the person] needed care right away for an illness or injury, how often did [person] get care as soon as you wanted?"</p><h3>National Numerator</h3><p>Subset of the denominator whose parents or guardians answered the above question "sometimes" or "never."</p><h3>Comments</h3><p>Nonrespondents and respondents indicating "don't know" were excluded.</p><p>The National Table reports data from the MEPS Child Health section. See the MEPS entry in the Data Sources appendix for more information.</p><p class="size2"><a href="#time">Top of Page</a></p><hr /> <a id="gapcmt81" name="gapcmt8"></a> <h2>Getting Appointments for Care</h2><h3>Measure Title</h3><p>Children who needed care right away for an illness, injury, or condition in the last 6 months who always got care as soon as wanted.</p><h3>Measure Source</h3><p>Agency for Healthcare Research and Quality (AHRQ), Center for Quality Improvement and Patient Safety (CQUIPS) , National Consumer Assessment of Healthcare Providers and Systems (CAHPS) Benchmarking Database.</p><h3>State Table</h3><p>13_1_4.3 Children who needed care right away for an illness, injury, or condition in the last 6 months who always got care as soon as wanted, Medicaid, by State, 2007-2009</p><h3>State Data Source</h3><p>AHRQ, CQUIPS, CAHPS.</p><h3>State Denominator</h3><p>Members of Medicaid and SCHIP enrollees.</p><h3>State Numerator</h3><p>Subset of the denominator whose parents or guardians indicated that needed care was "sometimes" or "never" received as soon as wanted.</p><p class="size2"><a href="#time">Top of Page</a></p><hr /> <a id="wtim1" name="wtim1"></a> <h2>Waiting Time</h2> <a id="wtimmt1" name="wtimmt1"></a> <h3>Measure Title</h3><p>Emergency department (ED) visits lasting 6 or more hours and resulting in admission to the hospital or transfer to another facility, per 1,000 ED visits.</p><h3>Measure Source</h3><p>Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Hospital Ambulatory Medical Care Survey (NHAMCS).</p><h3>National Tables</h3><p>13_2_1.1 Emergency department (ED) visits in which patient was admitted to the hospital or transferred to another facility whose ED visit was 6 hours or more, United States, 2007-2008</p><p>13_2_1.2 Emergency department (ED) visits in which patient was admitted to the hospital or transferred to another facility whose ED visit was 6 hours or more, United States 2001-2007</p><p>13_2_1.3a-b Emergency department (ED) visits in which patient was admitted to the hospital or transferred to another facility whose ED visit was 6 hours or more, United States, 2007-2008, by:</p><ul li="li"><li style=" list-style: none;">Race.</li><li>Source of payment.</li><li style=" list-style: none;"><h3>National Data Source</h3><p>CDC, NCHS, NHAMCS.</p><h3>National Denominator</h3><p>Visits to the ED where the patient was later admitted to the hospital or intensive care unit/critical care unit or transferred to another facility.</p><h3>National Numerator</h3><p>Subset of the denominator who remained in the ED for 6 hours or more.</p><h3>Comments</h3><p>The NHAMCS ED question refers to "Visit Disposition," where disposition includes admission to a hospital, admission to an intensive care unit or critical care unit, or transfer to another facility.</p><p class="size2"><a href="#time">Top of Page</a></p><hr /> <a id="wtimmt2" name="wtimmt2"></a> <h2>Waiting Time</h2><h3>Measure Title</h3><p>Emergency department (ED) visits where patients left without being seen.</p><h3>Measure Source</h3><p>Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Hospital Ambulatory Medical Care Survey (NHAMCS).</p><h3>National Tables</h3><p>13_2_2.1 Emergency department visits where patients left without being seen, United States, 2007-2008</p><p>13_2_2.2 Emergency department visits where patients left without being seen, United States, 1999-2007</p><p>13_2_2.3a Emergency department visits where patients left without being seen, United States, 2007-2008, by:</p><ul><li>Race.</li></ul><h3>National Data Source</h3><p>CDC, NCHS, NHAMCS.</p><h3>National Denominator</h3><p>Visits to emergency departments (EDs) and outpatient departments of noninstitutional general and short-stay hospitals, exclusive of Federal, military, and Veterans Affairs hospitals located in the 50 States and the District of Columbia.</p><h3>National Numerator</h3><p>Subset of the denominator with a visit disposition indicating the patient "left before being seen" as recorded on the NHAMCS Emergency Department Patient Record Form.</p><p class="size2"><a href="#time">Top of Page</a></p><hr /> <a id="wtimmt3" name="wtimmt3"></a> <h2>Waiting Time</h2><h3>Measure Title</h3><p>Hospital patients with heart attack who received percutaneous coronary intervention (PCI) within 90 minutes of arrival.</p><h3>Measure Source</h3><p>Centers for Medicare & Medicaid Services (CMS), Medicare Quality Improvement Organization (QIO) Program.</p><h3>National Table</h3><p>13_2_3.1 Hospital patients with heart attack who received percutaneous coronary intervention (PCI) within 90 minutes of arrival, United States, 2005-2008</p><h3>National Data Source</h3><p>CMS, QIO Program.</p><h3>National Denominator</h3><p>Discharged hospital patients with a principal diagnosis of acute myocardial infarction (AMI) and documented receipt of percutaneous transluminal angioplasty or stent placement during the hospital stay; excluding persons under age 18 and patients transferred from other acute care hospitals (including other emergency departments) and patients administered thrombolytic agents.</p><h3>National Numerator</h3><p>Subset of denominator who received PCI (angioplasty or stent placement) within 90 minutes of arrival.</p><h3>State Table</h3><p>13_2_3.2 Hospital patients with heart attack who received percutaneous coronary intervention (PCI) within 90 minutes of arrival, by State, 2005-2008</p><h3>State Data Source</h3><p>CMS, QIO.</p><h3>State Denominator</h3><p>Same as National.</p><h3>State Numerator</h3><p>Same as National.</p><h3>Comments</h3><p>Effective October 2003, CMS revised this measure. Rates may not be comparable with earlier versions of the reports.</p><p>ICD-9-CM codes for AMI include 410.01, 410.11, 410.21, 410.31, 410.41, 410.51, 410.61, 410.71, 410.81, and 410.91.</p><p>Time is measured in minutes from arrival to receipt of percutaneous transluminal coronary angiopathy (PTCA) in patients with ST segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time.</p><p>State Tables using Hospital Compare (HC) data were downloaded from <a href="http://www.medicare.gov/Download/DownloadDB.asp">http://www.medicare.gov/Download/DownloadDB.asp</a> in late April each year. Estimates are calculated using hospital-level scores.</p><p>For tables from QIO data, the estimate of the total is based on State-level estimates whereas the estimates for the demographic categories are based on patient/episode level data.</p><p>Further information on this and other heart disease measures is available at <a href="http://www.cms.hhs.gov/HospitalQualityInits/">http://www.cms.hhs.gov/HospitalQualityInits/</a>.</p><p class="size2"><a href="#time">Top of Page</a></p><hr /> <a id="wtimmt4" name="wtimmt4"></a> <h2>Waiting Time</h2><h3>Measure Title</h3><p>Hospital patients with heart attack who received fibrinolytic medication within 30 minutes of arrival.</p><h3>Measure Source</h3><p>Centers for Medicare & Medicaid Services (CMS), Medicare Quality Improvement Organization (QIO) Program.</p><h3>National Table</h3><p>13_2_4.1 Hospital patients with heart attack who received fibrinolytic medication within 30 minutes of arrival, United States, 2005-2008</p><h3>National Data Source</h3><p>CMS, QIO Program.</p><h3>National Denominator</h3><p>Discharged hospital patients with a principal diagnosis of acute myocardial infarction (AMI) and thrombolytic therapy documented during the hospital stay, excluding patients under age 18 and patients transferred from another acute care hospital (including another emergency department).</p><h3>National Numerator</h3><p>Subset of denominator who received thrombolytic therapy within 30 minutes of arrival.</p><h3>State Table</h3><p>13_2_4.2 Hospital patients with heart attack who received fibrinolytic medication within 30 minutes of arrival, by State, 2005-2008.</p><h3>State Data Source</h3><p>CMS, QIO Program.</p><h3>State Denominator</h3><p>Same as National.</p><h3>State Numerator</h3><p>Same as National.</p><h3>Comments</h3><p>ICD-9-CM codes for AMI include 410.01, 410.11, 410.21, 410.31, 410.41, 410.51, 410.61, 410.71, 410.81, and 410.91.</p><p>Time is measured in minutes from arrival to initiation of a thrombolytic agent in patients with ST segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time.</p><p>For State Tables from Hospital Compare (HC), data were downloaded from <a href="http://www.medicare.gov/Download/DownloadDB.asp">http://www.medicare.gov/Download/DownloadDB.asp</a> in late April each year. Estimates are calculated using hospital-level scores.</p><p>For those tables derived from QIO data, the estimate for the Total is based on State-level estimates whereas the estimates for demographic categories are based on patient/episode level data.</p><p>Further information on this and other heart disease measures is available at <a href="http://www.cms.hhs.gov/HospitalQualityInits/">http://www.cms.hhs.gov/HospitalQualityInits/</a>.</p><p>Effective October 2003, CMS revised this measure. Rates may not be comparable with earlier versions of the reports.</p><p class="size2"><a href="#time">Top of Page</a><br /><a href="/research/findings/nhqrdr/nhqrdr10/index.html">Return to Measure Specifications</a></p><p> </p></li></ul></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: Timeliness: 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/timeliness.html</span>
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