National Quality Measures Compared to Achievable Benchmarks

The NHQR quality measures are compared to achievable benchmarks, which are derived from the top-performing States. Better performance of a State can mean higher or lower values of a measure, depending on the desired outcome. For example, low values are desirable for measures such as infant mortality, whereas high values are desirable for measures such as preventative screening. The categories of achievement have been standardized across the measure definitions so that:

 
Far away from benchmark - the value for a measure has not achieved 50% of the benchmark.
 
Close to benchmark - the value for a measure is between 50% and 90% of a benchmark (i.e., worse than the benchmark but has achieved at least half of the benchmark but not as much as 90% of a benchmark).
 
Achieved benchmark or better - the the value for a measure is no worse than 90% of the benchmark value, the measure has achieved the benchmark. This category also includes the case in which the measure’s value is equal to or better than the benchmark.
Measures That Achieved Benchmark or Better
Measure Estimate Benchmark Distance to Benchmark
Stroke patients who received venous thromboembolism (VTE) prophylaxis 96.6 96.8 0%
Hospice patients who received care consistent with their stated end-of-life wishes 94.8 95.7 1%
Stroke patients prescribed statin medication at hospital discharge 96.4 97.3 1%
Adults who reported that home health providers always treated them with courtesy and respect, in the last 2 months of care 93.4 94.8 2%
Hospice patient caregivers who perceived patient was referred to hospice at the right time 90.4 92.2 2%
Stroke patients with educational material addressing activation of emergency medical system, follow-up after discharge, educations prescribed at discharge, risk factors for stroke, warning signs and symptoms of stroke 93.4 95.6 2%
Women with clinical Stage I-IIb breast cancer who received axillary node dissection or sentinel lymph node biopsy (SLNB) at the time of surgery (lumpectomy or mastectomy) 94.4 96.7 2%
Home health patients who had diabetic foot care and patient education - short stay 94.0 96.4 3%
Adults who reported that home health providers always treated them as gently as possible, in the last 2 months of care 90.1 92.4 3%
Hospital patients with heart failure discharged home with written instructions or educational material 94.6 97.2 3%
Home health patients who had drug education on all medications - short stay 92.7 95.3 3%
Adults who reported being told what care and services they would get when they first started getting home health care 88.7 91.3 3%
Hospital patients who received influenza vaccination 93.8 96.7 3%
Adults who reported having any problems with the care they received from their home health provider in the last 2 months of care 92.4 89.5 3%
Adults who reported that home health providers talk about pain in the last 2 months of care 88.5 91.4 3%
Home health patients who had timely initiation of care 91.7 94.9 3%
Home health care patients whose surgical wound was improved 89.0 92.2 3%
Long-stay nursing home patients who had flu vaccination appropriately given 90.8 94.3 4%
Family caregivers who did not want more information about what to expect while the patient was dying 85.4 88.8 4%
Adults who reported that home health providers always explained things in a way that was easy to understand, in the last 2 months of care 83.0 86.4 4%
Hospice patients who received the right amount of help for feelings of anxiety or sadness 90.7 94.4 4%
Adults who reported that home health providers always listen carefully to them, in the last 2 months of care 84.2 87.7 4%
Children ages 19-35 months who received 1 or more doses of varicella vaccine 91.0 94.9 4%
Children ages 19-35 months who received 3 or more doses of polio vaccine 93.3 97.3 4%
Long-stay nursing home residents who were assessed for pneumococcal vaccination 93.6 97.8 4%
Adults who reported that home health providers always kept them informed about when they would arrive at their home, in the last 2 months of care 79.4 83.0 4%
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined 90.1 94.4 5%
Adults who reported a home health provider talking with them about all the prescription and over-the-counter medicines you were taking, when they first started getting home health care 84.1 88.1 5%
Children ages 19-35 months who received 1 or more doses of measles-mumps-rubella vaccine 91.5 95.9 5%
Children ages 19-35 months who received 3 or more doses of hepatitis B vaccine 91.6 96.3 5%
Short-stay nursing home patients who had flu vaccination appropriately given 86.0 91.4 6%
Home health care patients whose pain when moving around decreased 68.0 72.8 7%
Short-stay nursing home residents who were assessed for pneumococcal vaccination 86.1 92.2 7%
Children ages 19-35 months who received 4 or more doses of diphtheria-tetanus-pertussis vaccine 84.2 90.2 7%
Adults who reported a home health provider talking with them about how to set up your home so you can move around safely when they first started getting home health care 75.6 81.0 7%
Adults who reported that home health providers always seem informed and up-to-date about all the care or treatment you got at home, in the last 2 months of care 63.1 67.8 7%
Adolescents ages 16-17 who received 1 or more doses of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) since the age of ten years 86.6 93.5 7%
Adolescents ages 13-15 who received 1 or more doses of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) since the age of ten years 88.3 95.3 7%
Home health care patients whose bathing improved 67.8 73.4 8%
Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis 88.7 96.6 8%
Hospital patients who received pneumococcal immunization 89.3 97.3 8%
Home health care patients who stayed at home after an episode of home health care 71.0 77.5 8%
Home health patients who had improvement in upper body dressing 70.5 77.1 9%
Adults who reported a home health provider asking to see all the prescription and over-the-counter medicines you were taking, when they first started getting home health care 77.8 86.3 10%
Home health care patients whose ability to walk or move around improved 61.8 68.6 10%
Measures That Are Close to Benchmark
Measure Estimate Benchmark Distance to Benchmark
Home health care patients whose shortness of breath decreased 65.0 72.3 10%
Home health care patients whose ability to get in and out of bed improved 57.5 64.1 10%
Home health patients who had improvement in toileting 68.8 76.9 11%
Acute stroke patients for whom IV thrombolytic therapy was initiated at hospital within 3 hours (less than or equal to 180 minutes) of time last known well 79.9 89.7 11%
Home health patients who had influenza vaccination during flu season 71.7 82.3 13%
Adults who reported that home health providers talked with them about the purpose for taking your new or changed prescription medicines, in the last 2 months of care 31.3 36.7 15%
Home health care patients whose management of oral medications improved 51.3 60.6 15%
Home health care patients whose urinary incontinence decreased 46.2 54.8 16%
Home health patients who had improvement in confusion frequency 44.3 52.9 16%
Home health patients who had pneumococcal polysaccharide vaccination 71.1 85.1 16%
Adults who reported that home health providers talked with them about when to take medicines, in the last 2 months of care 28.9 34.6 16%
Persons aged 16 to 17 years who received 1 or more doses of meningococcal conjugate vaccine 79.1 94.8 17%
Persons aged 13 to 15 years who received 1 or more doses of meningococcal conjugate vaccine 79.4 95.5 17%
Adults who reported getting the help or advice they needed when they contacted their home health provider , in the last 2 months of care 25.9 31.4 17%
Adults who reported that home health providers talked with them about the side effects of medicines, in the last 2 months of care 24.8 30.1 18%
Deaths per 1,000 adult hospital admissions with acute myocardial infarction (AMI) 44.6 36.8 21%
Breast cancer diagnosed at advanced stage (regional, distant stage, or local stage with tumor greater than 2 cm) per 100,000 women age 40 and over 88.1 72.3 22%
Adults who reported getting the help or advice they needed the same day they contacted their home health provider 19.2 24.7 22%
Deaths per 1,000 hospital admissions with coronary artery bypass surgery, age 40 and over 17.6 14.4 22%
Colorectal cancer deaths per 100,000 population per year 14.4 11.6 24%
Colorectal cancer diagnosed at advanced stage (tumors diagnosed at regional or distant stage) per 100,000 population age 50 and over 64.5 52.1 24%
Obstetric trauma per 1,000 vaginal deliveries without instrument assistance 18.7 15.1 24%
Obstetric trauma per 1,000 instrument-assisted deliveries 119.0 95.2 25%
Adolescent aged 13-15 years who received 3 or more doses of human papillomavirus (HPV) vaccine 27.3 36.7 26%
Long-stay nursing home residents with too much weight loss 9.20 7.32 26%
Adult hospital patients who sometimes or never had good communication about medications they received in the hospital 9.93 7.85 26%
Long-stay nursing home residents with a urinary tract infection 6.40 5.02 27%
Deaths per 1,000 hospital admissions with percutaneous transluminal coronary angioplasty (PTCA), age 40 and over 15.5 12.1 28%
Long-stay nursing home residents whose need for help with daily activities increased 17.4 13.6 28%
Breast cancer deaths per 100,000 female population per year 20.6 15.9 30%
Adolescent ages 16-17 years who received 3 or more doses of human papillomavirus (HPV) vaccine 35.0 50.9 31%
Home health care patients who received urgent, unplanned medical care 21.1 16.0 32%
Low-risk, long-stay nursing home residents with loss of control of bowels or bladder 43.9 33.2 32%
Birth trauma - injury to neonate per 1,000 selected live births 1.86 1.38 34%
End stage renal disease (ESRD) patients who saw a nephrologist at least 12 months prior to initiation of renal replacement therapy, age 18 and over 35.0 53.6 35%
Adult hospital patients who did not receive good communication about discharge information 10.9 7.95 36%
Postoperative sepsis per 1,000 elective-surgery admissions of length 4 or more days, adults 16.7 12.2 37%
Short-stay nursing home patients who had antipsychotic medication 1.90 1.38 38%
Home health care patients who had an emergency department visit and then hospitalized 17.6 12.8 38%
Deaths per 1,000 adult hospital admissions with pneumonia 20.4 14.8 38%
Deaths per 1,000 adult hospital admissions with congestive heart failure 17.1 12.3 39%
Home health care patients who had to be admitted to the hospital 24.8 17.6 41%
Dialysis patients who were registered on a waiting list for transplantation 17.1 29.6 42%
Cervical cancer diagnosed at advanced stage (all invasive tumors) per 100,000 women age 20 and over 10.1 7.10 42%
Short-stay nursing home residents with moderate to severe pain 18.8 12.6 49%
Hospital admissions for short-term complications of diabetes per 100,000 population, ages 6-17 24.3 16.3 49%
Low-risk, short-stay nursing home patients who had pressure ulcer 1.30 0.87 50%
Long-stay nursing home patients who had antipsychotic medication 17.6 11.7 50%
Measures That Are Far From Benchmark
Measure Estimate Benchmark Distance to Benchmark
Lung cancer deaths per 100,000 population per year 42.1 28.0 50%
Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure 13.7 28.4 52%
Suicide deaths per 100,000 population 15.7 10.2 53%
Hospital admissions for short-term complications of diabetes per 100,000 population, adults 81.5 52.3 56%
Low-risk, long-stay nursing home residents with a catheter inserted and left in the bladder 4.50 2.88 56%
Avoidable admissions for bacterial pneumonia per 100,000 population age 18 and over 255.8 160.3 60%
Hospital admissions for congestive heart failure per 100,000 population 331.6 198.8 67%
High-risk, long-stay nursing home patients who had pressure ulcer 7.70 4.57 68%
Adult hospital patients who strongly disagree or disagree that staff took their preferences and those of their family and caregiver into account when deciding what the patients discharge health care would be 5.40 3.18 70%
Long-stay nursing home residents with moderate to severe pain 10.00 5.88 70%
Long-stay nursing home patients who had fall with major injury 3.40 1.96 73%
Hospital admissions for lower extremity amputations per 1,000 population age 18 and over with diabetes, HCUP data 18.7 9.70 93%
Hospital admissions for asthma per 100,000 population, age 18 to 39 46.6 24.1 94%
Avoidable admissions for chronic obstructive pulmonary disease or asthma per 100,000 population age 40 and over 431.8 218.6 98%
Hospital admissions for long-term complications of diabetes per 100,000 population, adults 115.9 52.6 120%
Hospital admissions for asthma per 100,000 population, ages 2-17 106.3 47.7 123%
Avoidable admissions for angina per 100,000 population age 18 and over 11.9 5.05 136%
Hospital admissions for immunization-preventable influenza per 100,000 population age 65 and over 146.0 56.2 160%
Avoidable admissions for hypertension per 100,000 population age 18 and over 54.2 20.4 166%
HIV infection deaths per 100,000 population 2.00 0.73 173%
Long-stay nursing home residents whose depression or anxiety increased 7.30 2.54 187%
Long-stay nursing home residents with physical restraints 1.40 0.44 218%
Hospital admissions with iatrogenic pneumothorax per 1,000 medical and surgical admissions, adults 0.93 0.29 224%
Hospital admissions for uncontrolled diabetes without complications per 100,000 population, adults, HCUP data 14.2 4.10 245%
Measures With No Available Benchmark Information
Measure Estimate Benchmark Distance to Benchmark
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 needed 12.4
Adult surgery patients with postoperative catheter-associated urinary tract infection 2.55
Admissions with central venous catheter-related bloodstream infection per 1,000 medical and surgical discharges of length 2 or more days, age 18 and over or obstetric admissions 0.67
Adult surgery patients with postoperative pneumonia events 1.76
Adult surgery patients with postoperative venous thromboembolic events 0.45
Postoperative hemorrhage or hematoma with surgical drainage or evacuation per 1,000 surgical hospital discharges, adults 2.34
Postoperative pulmonary embolism (PE) or deep vein thrombosis (DVT) per 1,000 surgical hospital discharges, adults 8.02
Postoperative respiratory failure per 1,000 elective surgical hospital discharges, adults 6.39
Postoperative physiologic and metabolic derangements per 1,000 elective surgical hospital discharges, adults 1.83
Postoperative hip fracture per 1,000 surgical admissions who were not susceptible to falling, adults 0.13
Reclosure of postoperative abdominal wound dehiscence per 1,000 abdominopelvic-surgery admissions of length 2 or more days, adults 1.19
Adult patients receiving hip joint replacement due to degenerative conditions with adverse events 2.91
Adult patients receiving hip joint replacement due to fracture with adverse events 9.76
Adults who had any appointments for routine health care in the last 12 months who sometimes or never got an appointment for routine care as soon as needed 13.3
Children who had any appointments for routine health care in the last 12 months who sometimes or never got an appointment for routine care as soon as needed 5.30
Children who had a doctor's office or clinic visit in the last 12 months and needed care, tests, or treatment who sometimes or never found it easy to get the care, tests, or treatment 5.20
People under age 65 with health insurance 86.7
People under age 65 with any private health insurance 63.7
Adults age 65 and over with any private health insurance 49.3
People under age 65 who were uninsured all year 16.8
People under age 65 with any period of uninsurance during the year 32.5
People with a specific source of ongoing care 87.9
People with a usual primary care provider 72.3
People in fair or poor health with a specific source of ongoing care 90.5
People who were unable to get or delayed in getting needed medical care in the last 12 months 5.10
People who were unable to get or delayed in getting needed dental care in the last 12 months 6.70
People who were unable to get or delayed in getting needed prescription medicines in the last 12 months 4.30
People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends 37.6
People with a usual source of care who is somewhat to very difficulty to contact during regular business hours over the telephone 15.3
Adults who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist 14.0
Children who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist 13.6
Adults who had a doctor's office or clinic visit in the last 12 months and needed care, tests, or treatment who sometimes or never found it easy to get the care, tests, or treatment 7.60
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, children 0.54
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, adults 2.63
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never listened carefully to them 6.60
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never explained things in a way they could understand 4.80
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never showed respect for what they had to say 5.00
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never spent enough time with them 9.20
Children who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never spent enough time with them 4.40
Adult patients receiving knee replacement with adverse events 2.63
Mechanical adverse events in adult patients receiving central venous catheter placement 3.29
Deaths per 1,000 elective-surgery admissions having developed specified complications of care during hospitalization, ages 18-89 or obstetric admissions 113.3
Deaths per 1,000 hospital admissions with expected low-mortality 0.32
Hospital patients with an anticoagulant-related adverse drug event to warfarin 4.79
Adverse drug event with IV heparin in adult hospital patients who received an anticoagulant 11.1
Hospital patients with an anticoagulant-related adverse drug event to low-molecular-weight heparin (LMWH) and factor Xa 3.52
Hospital patients who received a hypoglycemic agent who had an adverse drug events with hypoglycemic agents 8.76
Adults age 65 and over who received in the calendar year at least 1 of 11 prescription medications that should be avoided in older adults 1.60
Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults 11.7
Adults with limited English proficiency who had a usual source of care 58.5
People with a usual source of care who sometimes or never asked person to help make decisions when there was a choice between treatments 14.9
Potentially avoidable hospitalizations and emergency department encounters for congestive heart failure 377.7
Hospital admissions for perforated appendix per 1,000 admissions with appendicitis, adults 363.2
Hospital admissions for perforated appendix per 1,000 admissions with appendicitis, children 411.4
Rating of health care 0-6 on a scale from 0 to 10 (best grade) by adults who had a doctor's office or clinic visit in the last 12 months 10.3
Adults with limited English proficiency and usual source of care (USC) by whether the USC had language assistance 91.2
Emergency department visits with a principal diagnosis related to dental conditions 337.0
Potentially avoidable emergency department encounters for asthma, adults 594.1
Potentially avoidable emergency department encounters for asthma, children ages 2-17 957.6
People with a usual source of care who usually asks about prescription medications and treatments from other doctors 80.8
Emergency department visits with a principal diagnosis related to mental health only per 100,000 population 1391.0
Emergency department visits with a principal diagnosis related to substance abuse only, per 100,000 population 640.0
Emergency department visits with a principal diagnosis related to co-occurring of mental health, alcohol and substance abuse, per 100,000 population 41.0
Adult hemodialysis patients with adequate dialysis (Kt/V 1.2 or higher) 93.0
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c measurements in the calendar year 75.1
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year 61.5
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year 71.4
Adults age 40 and over with diagnosed diabetes who received a flu vaccination in the calendar year 59.2
Adults age 40 and over with diabetes whose condition was diagnosed 77.1
Admissions for dehydration per 100,000 population, age 18 and over 97.5
Admissions for urinary tract infection (UTI) per 100,000 population, age 18 and over 172.0
Admissions for urinary tract infection (UTI) per 100,000 population, ages 3 months to 17 years 27.1
Admissions for pediatric gastroenteritis per 100,000 population, ages 3 months to 17 years 36.5
Adults with hypertension with blood pressure less than 140/90 mm/Hg 47.8
Hospital patients with heart attack given fibrinolytic medication within 30 minutes of arrival 60.4
Deaths per 1,000 adult hospital admissions with abdominal aortic aneurysm (AAA) repair 29.6
Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months 67.2
Children with obesity 2-19 years of age who had been told by a doctor or health professional that they were overweight 48.5
Adults with obesity age 20 and over who had been told by a doctor or health professional that they were overweight 68.4
Children ages 2-5 with obesity 8.90
Children ages 6-11 with obesity 17.5
Children ages 12-19 with obesity 20.5
Adults with obesity who ever received advice from a health professional to exercise more 62.1
Adults with obesity who do not now spend half an hour or more in moderate or vigorous physical activity at least five times a week 57.5
Children ages 2-17 for whom a health provider gave advice within the past 2 years about the amount and kind of exercise, sports, or physically active hobbies they should have 43.9
Adults with obesity who ever received advice from a health professional about eating fewer high-fat or high-cholesterol foods 50.1
Children ages 2-17 for whom a health provider gave advice within the past 2 years about eating healthy 60.5
Adults age 40 and over with diagnosed diabetes with hemoglobin A1c less than 8.0% (optimal control) 67.6
Adults age 40 and over with diagnosed diabetes with blood pressure less than 130/80 mm Hg 50.6
End stage renal disease (ESRD) due to diabetes per million population 158.9
Infant mortality per 1,000 live births, birth weight 2,500 grams or more 2.00
Adult current smokers with a checkup in the last 12 months who received advice to quit smoking 67.4
Children ages 12-17 with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months 39.3
People age 12 and over who needed treatment for illicit drug use and who received such treatment at a specialty facility in the last 12 months 18.3
People age 12 and over who needed treatment for alcohol problem who received such treatment at a specialty facility in the last 12 months 8.20
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms 71.3
People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler) 23.5
Persons with current asthma who received written asthma management plans from their healthcare provider 40.5
Persons with current asthma who received education about appropriate response to an asthma episode 68.7
Persons with current asthma who were advised to change things to reduce exposure to irritants 47.3
Live-born infants with low birth weight (less than 2,500 g) 8.00
Women who completed a pregnancy in the last 12 months who received early and adequate prenatal care 15.1
Infant mortality per 1,000 live births, birth weight less than 1,500 grams 220.0
Infant mortality per 1,000 live births, birth weights 1,500-2,499 grams 13.4
Women ages 21-65 who received a Pap smear in the last 3 years 80.7
Women ages 50-74 who received a mammogram in the last 2 years 72.6
Adolescents females ages 13-15 who received 3 or more doses human papillomavirus vaccine 34.4
Adults ages 18-64 at high risk (e.g., COPD) who ever received pneumococcal vaccination 20.2
Children ages 2-17 who had a dental visit in the calendar year 54.4
Adolescents females ages 16-17 who received 3 or more doses human papillomavirus vaccine 47.5
Children ages 12-17 with untreated dental caries 16.6
Children ages 5-11 with untreated dental caries 18.1
People without a usual source of care who indicated a financial or insurance reason for not having a source of care 20.5
Children ages 0-17 with wellness checkup in the past 12 months 83.8
People unable to get or delayed in getting needed medical care due to financial or insurance reasons 54.9
Adults ages 18-64 at high risk (e.g., COPD) who received an influenza vaccination in the last 12 months 47.2
Adults age 65 and over who ever received pneumococcal vaccination 61.3
Children ages 5-17 with untreated dental caries 17.4
Children ages 3-5 who ever had their vision checked by a health provider 66.2
Children for whom a health provider gave advice within the past 2 years about how smoking in the house can be bad for a child 43.0
People unable to get or delayed in getting needed dental care due to financial or insurance reasons 74.8
People unable to get or delayed in getting needed prescription medicines due to financial or insurance reasons 60.3
Children 0-40 lbs for whom a health provider gave advice within the past 2 years about using a child safety seat while riding in the car 64.6
Children 41-80 lb for whom a health provider gave advice within the past 2 years about using a booster seat when riding in the car 40.6
Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high 91.8
Adolescent males ages 13-15 years who received 3 or more doses of human papillomavirus (HPV) vaccine 20.6
Adolescent males ages 16-17 years who received 3 or more doses of human papillomavirus (HPV) vaccine 23.1
Adults who received a blood cholesterol measurement in the last 5 years 85.5
People under age 65 whose family's health insurance premium and out-of-pocket medical expenditures were more than 10% of total family income 13.7
Children over 80 lb for whom a health provider gave advice within the past 2 years about using lap or shoulder belts when riding in a car 36.2
Adults ages 18 and over who received influenza vaccination 42.9
Adults age 65 and over who received an influenza vaccination in the last 12 months 70.9
Children ages 2-17 for whom a health provider gave advice within the past 2 years about using a helmet when riding a bicycle or motorcycle 36.8
Children ages 6 months to 17 years who received influenza vaccination 52.7
Children who had their height and weight measured by a health provider within the past 2 years 92.4