NationalAmerican Indian/Alaska Native (AI/AN) Quality Measures Compared to Achievable Benchmarks

The NHQDR quality measures specific to American Indian/Alaska Native (AI/AN) 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 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 Population Estimate Benchmark Distance to Benchmark
Breast cancer deaths per 100,000 female population per year AI/AN 11.4 17.8 Achieved: 36% better
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 AI/AN 56.0 73.8 Achieved: 24% better
Lung cancer deaths per 100,000 population per year AI/AN 23.5 27.5 Achieved: 14% better
Adult hemodialysis patients who use arteriovenous fistulas as the primary mode of vascular access AI/AN 76.6 72.8 Achieved: 5% better
Colorectal cancer deaths per 100,000 population per year AI/AN 11.0 11.5 Achieved: 5% better
Adults who received a blood cholesterol measurement in the last 5 years AI/AN, single race 85.4 82.3 Achieved: 4% better
Long-stay nursing home residents with a urinary tract infection Non-Hispanic, AI/AN 2.7 2.8 Achieved: 3% better
Home health care patients whose ability to get in and out of bed improved Non-Hispanic, AI/AN 74.7 72.6 Achieved: 3% better
Home health care patients whose management of oral medications improved Non-Hispanic, AI/AN 67.3 66.2 Achieved: 2% better
Home health care patients whose pain when moving around decreased Non-Hispanic, AI/AN 76.0 75.1 Achieved: 1% better
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) Non-Hispanic, AI/AN 96.9 96.4 Achieved: 1% better
Home health care patients whose ability to walk or move around improved Non-Hispanic, AI/AN 74.5 74.2 -0.4%
Adult hemodialysis patients with adequate dialysis - (Kt/V) 1.2 or higher AI/AN 96.7 96.5 -0.2%
Home health patients who had influenza vaccination during flu season Non-Hispanic, AI/AN 94.1 94.1 0.0%
Home health care patients whose bathing improved Non-Hispanic, AI/AN 77.8 78.2 0.5%
Adults age 65 and over who received an influenza vaccination in the last flu season AI/AN, single race 69.6 70.3 1.0%
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined Non-Hispanic, AI/AN 93.8 95.4 1.7%
Long-stay nursing home patients who were assessed and appropriately given the seasonal influenza vaccine Non-Hispanic, AI/AN 92.2 93.9 1.9%
Adults who reported that home health providers talk about pain in the last 2 months of care AI/AN, single race 89.5 91.2 1.9%
Home health patients who had improvement in upper body dressing Non-Hispanic, AI/AN 77.6 79.3 2.1%
Cervical cancer diagnosed at advanced stage (all invasive tumors) per 100,000 women age 20 and over AI/AN 7.9 7.7 2.3%
Home health care patients whose surgical wound was improved Non-Hispanic, AI/AN 90.8 93.1 2.5%
Home health care patients whose shortness of breath decreased Non-Hispanic, AI/AN 76.2 78.4 2.8%
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 AI/AN single race 92.2 95.2 3.2%
Children ages 19-35 months who received 3 or more doses of polio vaccine AI/AN single race 93.8 97.3 3.6%
Adults who did not have any problem with the care they received from their home health providers in the last 2 months of care AI/AN, single race 90.6 94.0 3.6%
Adults who reported a home health provider asking to see all the prescription and over-the-counter medicines they were taking, when they first started getting home health care AI/AN, single race 82.1 85.5 4.0%
Adults who reported that home health providers always treated them with courtesy and respect in the last 2 months of care AI/AN, single race 91.2 95.0 4.0%
Hospice patients whose hospice care team always communicated well with their family caregivers about taking care them AI/AN 79.7 83.3 4.3%
Adults who reported getting the help or advice they needed when they contacted their home health providers in the last 2 months of care AI/AN, single race 29.1 30.4 4.3%
Adults who reported a home health provider talking with them about all the prescription and over-the-counter medicines they were taking when they first started getting home health care AI/AN, single race 84.2 88.2 4.6%
Adults who reported that home health providers always treated them as gently as possible in the last 2 months of care AI/AN, single race 87.9 92.5 4.9%
Children ages 19-35 months who received 4 or more doses of diphtheria-tetanus-pertussis vaccine AI/AN single race 86.0 90.6 5.1%
Home health patients who had improvement in toileting Non-Hispanic, AI/AN 74.8 78.9 5.2%
Adults who reported being told what care and services they would get when they first started getting home health care AI/AN, single race 86.5 91.3 5.3%
Hospice patients whose hospice care team always treated them with dignity and respect, and really cared about them AI/AN 87.2 92.1 5.3%
Long-stay nursing home residents with too much weight loss Non-Hispanic, AI/AN 5.0 4.7 5.5%
Adults home health patients age 18 and over who reported that home health providers talked with them about the side effects of medicines in the last 2 months of care AI/AN, single race 27.9 29.5 5.6%
Home health care patients who stayed at home after an episode of home health care Non-Hispanic, AI/AN 80.7 85.5 5.7%
Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis Non-Hispanic, AI/AN 90.7 96.2 5.7%
Adults who reported that home health providers always listen carefully to them in the last 2 months of care AI/AN, single race 82.7 87.9 6.0%
Family caregivers who received right amount of emotional and spiritual supports from hospice care team AI/AN 85.5 90.9 6.0%
Family members who definitely received trainings about taking care their family member from hospice care team AI/AN 73.4 78.4 6.3%
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 AI/AN, single race 78.0 83.3 6.3%
Adults who reported a home health provider talking with them about how to set up their home so they can move around safely when they first started getting home health care AI/AN, single race 75.0 80.1 6.4%
Adults who reported that home health providers talked with them about when to take medicines in the last 2 months of care AI/AN, single race 31.7 33.9 6.4%
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 AI/AN, single race 81.1 86.8 6.5%
Children ages 19-35 months who received 1 or more doses of measles-mumps-rubella vaccine AI/AN single race 89.9 96.4 6.7%
Adults who reported that home health providers talked with them about the purpose for taking their new or changed prescription medicines in the last 2 months of care AI/AN, single race 33.5 35.9 6.8%
Children ages 19-35 months who received 1 or more doses of varicella vaccine AI/AN single race 89.2 95.7 6.8%
Hospice patients who always received enough helps for pain, sadness, breathing, or constipations from hospice care team AI/AN 73.6 79.0 6.8%
Family caregivers who rated the hospice care for their family member best (9-10) on a scale of 0-10 (where 0 is the worst and 10 is the best) AI/AN 78.2 83.9 6.8%
Long-stay nursing home residents who were assessed for pneumococcal vaccination Non-Hispanic, AI/AN 90.0 97.0 7.3%
Adults who reported that home health providers always seem informed and up-to-date about all the cares or treatments they got at home in the last 2 months of care AI/AN, single race 62.6 67.6 7.4%
Hospice patients and family caregivers who always got help as soon as they need from hospice care team AI/AN 76.2 82.3 7.5%
Family caregivers who would definitely recommend this hospice to their friends and family AI/AN 81.6 88.4 7.7%
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 AI/AN single race 88.4 95.9 7.8%
Children ages 19-35 months who received 3 or more doses of hepatitis B vaccine AI/AN single race 88.8 96.4 7.8%
Short-stay nursing home patients who had flu vaccination appropriately given Non-Hispanic, AI/AN 84.8 92.2 8.0%
Long-stay nursing home residents whose ability to move independently worsened Non-Hispanic, AI/AN 22.5 20.7 8.7%
Colorectal cancer diagnosed at advanced stage (tumors diagnosed at regional or distant stage) per 100,000 population age 50 and over AI/AN 52.9 48.6 8.8%
Measures That Are Close to Benchmark
Measure Population Estimate Benchmark Distance to Benchmark
Short-stay nursing home residents who were assessed for pneumococcal vaccination Non-Hispanic, AI/AN 82.1 91.4 10.1%
Adults who reported getting the help or advice they needed the same day they contacted their home health providers AI/AN, single race 21.4 23.8 10.2%
Home health patients who had pneumococcal polysaccharide vaccination Non-Hispanic, AI/AN 81.7 91.0 10.3%
Adolescents ages 16-17 who received 1 or more doses of meningococcal conjugate vaccine AI/AN single race 85.7 96.2 10.9%
Persons age 13 and over living with HIV who know their serostatus Non-Hispanic, AI/AN 81.6 91.9 11.2%
Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment AI/AN 83.8 95.4 12.2%
Infants born in the calendar year who received breastfeeding exclusively through 3 months Non-Hispanic, AI/AN 55.1 63.6 13.3%
Hospital patients who received influenza vaccination AI/AN 83.3 96.6 13.8%
Adults age 65 and over who ever received pneumococcal vaccination AI/AN, single race 67.6 78.7 14.1%
Women ages 21-65 who received a Pap smear in the last 3 years AI/AN, single race 71.7 84.2 14.8%
Persons age 13 and over living with diagnosed HIV who had at least two CD4 or viral load tests performed at least 3 months apart during the last year, among reporting jurisdictions Non-Hispanic, AI/AN 56.2 66.2 15.1%
Adults ages 18-64 at high risk (e.g., COPD) who received an influenza vaccination in the last flu season AI/AN, single race 39.7 47.8 16.9%
Long-stay nursing home residents whose need for help with daily activities increased Non-Hispanic, AI/AN 20.1 17.1 17.7%
Adult hospital patients who sometimes or never had good communication about medications they received in the hospital AI/AN, single race 9.3 7.8 19.8%
HIV infection deaths per 100,000 population AI/AN 0.9 0.8 20.0%
Persons age 13 and over living with diagnosed HIV whose most recent viral load in the last 12 months was under 200 copies/mL Non-Hispanic, AI/AN 59.6 76.1 21.7%
Hemodialysis patients whose hemoglobin level is less than 10 g/dL AI/AN 19.8 16.1 22.7%
Women ages 50-74 who received a mammogram in the last 2 years AI/AN, single race 64.4 84.7 24.0%
Adults ages 18-64 at high risk (e.g., COPD) who ever received pneumococcal vaccination AI/AN, single race 31.0 44.8 30.8%
Drug overdose deaths involving natural and semisynthetic opioids per 100,000 resident population AI/AN 2.5 1.9 32.6%
Adult end stage renal disease (ESRD) patients who saw a nephrologist at least 12 months prior to initiation of renal replacement therapy AI/AN 30.7 54.1 43.2%
Short-stay nursing home residents with moderate to severe pain Non-Hispanic, AI/AN 15.4 10.5 46.7%
Home health care patients who had to be admitted to the hospital Non-Hispanic, AI/AN 15.6 10.5 48.6%
Measures That Are Far From Benchmark
Measure Population Estimate Benchmark Distance to Benchmark
Adult hospital patients who did not receive good communication about discharge information AI/AN, single race 11.6 7.7 50.3%
Dialysis patients who were registered on a waiting list for transplantation AI/AN 12.6 28.2 55.3%
Home health care patients who had an emergency department visit and then hospitalized Non-Hispanic, AI/AN 13.8 8.9 55.8%
Low-risk, long-stay nursing home residents with a catheter inserted and left in the bladder Non-Hispanic, AI/AN 3.3 2.1 56.5%
Long-stay nursing home patients experiencing one or more falls with major injury Non-Hispanic, AI/AN 0.7 0.4 58.1%
Adolescent males ages 13-15 who received 3 or more doses of human papillomavirus (HPV) vaccine AI/AN single race 13.5 43.2 68.8%
Suicide deaths among persons age 12 and over per 100,000 population AI/AN 16.3 9.4 73.8%
Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure AI/AN 6.4 28.8 77.8%
Long-stay nursing home residents with physical restraints Non-Hispanic, AI/AN 0.5 0.3 77.8%
Home health care patients who had an emergency department visit without a hospitalization Non-Hispanic, AI/AN 5.1 2.8 83.6%
Short-stay nursing home patients with pressure ulcers that are new or worsened Non-Hispanic, AI/AN 0.6 0.3 93.5%
Drug overdose deaths involving any opioid per 100,000 resident population AI/AN 9.2 4.0 127.7%
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 AI/AN, single race 7.7 3.2 139.4%
Long-stay nursing home residents with moderate to severe pain Non-Hispanic, AI/AN 10.5 4.3 142.0%
High-risk, long-stay nursing home patients with pressure ulcer Non-Hispanic, AI/AN 8.0 3.0 165.1%
New HIV cases per 100,000 population age 13 and over Non-Hispanic, AI/AN 11.9 4.2 183.3%
People age 12 and over with opioid (either prescription opioid or heroin) use disorder in the past year AI/AN, single race 0.9 0.3 196.7%
Long-stay nursing home residents have depressive symptoms Non-Hispanic, AI/AN 3.8 1.1 238.9%
Drug overdose deaths involving other synthetic opioids (other than methadone) per 100,000 resident population AI/AN 4.7 0.7 541.1%
Measures With No Available Benchmark Information
Measure Population Estimate Benchmark Distance to Benchmark
People under age 65 whose family's health insurance premium and out-of-pocket medical expenditures were more than 10% of total family income AI/AN, single race 19.9
People under age 65 with health insurance AI/AN, single race 71.4
People under age 65 with any private health insurance AI/AN, single race 34.3
Adults age 65 and over with any private health insurance AI/AN, single race 25.7
People under age 65 who were uninsured all year AI/AN, single race 22.1
People under age 65 with any period of uninsurance during the year AI/AN, single race 38.8
People with a specific source of ongoing care AI/AN, single race 88.1
People with a usual primary care provider AI/AN, single race 67.5
People in fair or poor health with a specific source of ongoing care AI/AN, single race 94.0
People who were unable to get or delayed in getting needed medical care in the last 12 months AI/AN, single race
People who were unable to get or delayed in getting needed dental care in the last 12 months AI/AN, single race
People who were unable to get or delayed in getting needed prescription medicines in the last 12 months AI/AN, single race
People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends AI/AN, single race 39.9
People with a usual source of care who is somewhat to very difficulty to contact during regular business hours over the telephone AI/AN, single race 14.8
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 AI/AN, single race
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 AI/AN, single race 19.1
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 AI/AN, single race 28.0
Adults who rated their healthcare received in the last 12 months as poor (0-6) on a scale of 0-10 (where 0 is the worst and 10 is the best) AI/AN, single race 25.6
People with a usual source of care whose providers sometimes or never asked them to help make decisions when there was a choice between treatments AI/AN, single race
People with a usual source of care who usually asks about prescription medications and treatments from other doctors AI/AN, single race 91.6
Adjusted incident rates of end stage renal disease (ESRD) due to diabetes per million population AI/AN 274.9
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 AI/AN, single race 5.0
People age 12 and over who needed treatment for alcohol problem who received such treatment at a specialty facility in the last 12 months AI/AN, single race 8.2
Adults who filled an outpatient opioid prescription in the calendar year AI/AN, single race 19.6
Adults who filled four or more outpatient opioid prescriptions in the calendar year AI/AN, single race 8.6
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms AI/AN, single race 70.5
Live-born infants with low birth weight (less than 2,500 g) AI/AN 8.0
Infant mortality per 1,000 live births, birth weight 2,500 grams or more AI/AN 3.9
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 AI/AN, single race
Children ages 2-17 for whom a health provider gave advice within the past 2 years about eating healthy AI/AN, single race
Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high AI/AN, single race 91.9
Adults ages 18 and over who received influenza vaccination in the last flu season AI/AN, single race 44.0
Adults with a dental visit in the calendar year AI/AN, single race 31.3
Adults who received a preventive dental service in the calendar year AI/AN, single race 18.7
Children ages 6 months to 17 years who received influenza vaccination in the last flu season AI/AN, single race 50.4
Children who had their height and weight measured by a health provider within the past 2 years AI/AN, single race 86.8
Children ages 2-17 who had a dental visit in the calendar year AI/AN, single race
Children ages 2-17 who received a preventive dental service in the calendar year AI/AN, single race
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 AI/AN, single race
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 AI/AN, single race
Children ages 0-17 with wellness checkup in the past 12 months AI/AN, single race 75.3