NationalHigh Income Quality Measures Compared to Achievable Benchmarks

The NHQR quality measures specific to High Income 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 Population Estimate Benchmark Distance to Benchmark
Hospital admissions for short-term complications of diabetes per 100,000 population, adults Fourth quartile (highest income) 43.4 56.8 Achieved: 24% better
Children ages 19-35 months who received 4 or more doses of diphtheria-tetanus-pertussis vaccine High 92.0 90.6 Achieved: 2% better
Women ages 21-65 who received a Pap smear in the last 3 years High 88.0 86.9 Achieved: 1% better
Children ages 19-35 months who received 1 or more doses of varicella vaccine High 95.1 95.7 1%
Children ages 19-35 months who received 3 or more doses of polio vaccine High 96.3 97.3 1%
Children ages 19-35 months who received 1 or more doses of measles-mumps-rubella vaccine High 94.5 96.4 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) High 94.4 96.8 2%
Children ages 19-35 months who received 3 or more doses of hepatitis B vaccine High 92.2 96.4 4%
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined High 91.7 95.9 4%
Hospital admissions for bacterial pneumonia per 100,000 population, adults age 18 and over Fourth quartile (highest income) 171.0 161.5 6%
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 High 89.4 95.2 6%
Women ages 50-74 who received a mammogram in the last 2 years High 78.9 85.2 7%
Hospital admissions for lower extremity amputations per 1,000 population, adults age 18 and over with diabetes Fourth quartile (highest income) 9.90 9.03 10%
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 High 86.6 95.9 10%
Measures That Are Close to Benchmark
Measure Population Estimate Benchmark Distance to Benchmark
Hospital admissions for chronic obstructive pulmonary disease or asthma per 100,000 population, adults age 40 and over Fourth quartile (highest income) 242.4 216.7 12%
Adolescents ages 13-15 who received 1 or more doses of meningococcal conjugate vaccine High 83.2 95.4 13%
Adolescents ages 16-17 who received 1 or more doses of meningococcal conjugate vaccine High 83.8 96.2 13%
Deaths per 1,000 hospital admissions with percutaneous transluminal coronary angioplasty (PTCA), adults age 40 and over Fourth quartile (highest income) 13.4 11.4 18%
Deaths per 1,000 adult hospital admissions with acute myocardial infarction (AMI) Fourth quartile (highest income) 42.0 35.5 18%
Deaths per 1,000 hospital admissions with coronary artery bypass surgery, adults age 40 and over Fourth quartile (highest income) 16.1 13.6 19%
Hospital admissions for asthma per 100,000 population, adults ages 18-39 Fourth quartile (highest income) 24.4 20.4 20%
Hospital admissions for congestive heart failure per 100,000 population Fourth quartile (highest income) 245.8 202.0 22%
Hospital admissions for long-term complications of diabetes per 100,000 population, adults Fourth quartile (highest income) 67.8 54.8 24%
Adolescent ages 16-17 years who received 3 or more doses of human papillomavirus (HPV) vaccine High 43.8 62.2 30%
Sepsis diagnoses per 1,000 elective-surgery admissions of length 4 or more days, adults Fourth quartile (highest income) 13.5 10.4 30%
Hospital admissions for short-term complications of diabetes per 100,000 population, children ages 6-17 Fourth quartile (highest income) 17.8 13.6 31%
Deaths per 1,000 adult hospital admissions with pneumonia Fourth quartile (highest income) 16.8 12.8 31%
Adolescent aged 13-15 years who received 3 or more doses of human papillomavirus (HPV) vaccine High 30.3 46.4 35%
Adolescent males ages 13-15 who received 3 or more doses of human papillomavirus (HPV) vaccine High 25.9 43.3 40%
Hospital admissions for asthma per 100,000 population, children ages 2-17 Fourth quartile (highest income) 54.9 38.1 44%
Deaths per 1,000 adult hospital admissions with congestive heart failure Fourth quartile (highest income) 17.0 11.5 48%
Obstetric trauma per 1,000 instrument-assisted deliveries Fourth quartile (highest income) 140.5 94.3 49%
Hospital admissions for hypertension per 100,000 population, adults age 18 and over Fourth quartile (highest income) 30.4 20.4 49%
Measures That Are Far From Benchmark
Measure Population Estimate Benchmark Distance to Benchmark
Birth trauma - injury to neonate per 1,000 selected live births Fourth quartile (highest income) 2.00 1.29 55%
Obstetric trauma per 1,000 vaginal deliveries without instrument assistance Fourth quartile (highest income) 22.2 14.1 57%
Hospital admissions for angina per 100,000 population, adults age 18 and over Fourth quartile (highest income) 8.30 4.90 69%
Hospital admissions for uncontrolled diabetes without complications per 100,000 population, adults Fourth quartile (highest income) 5.80 3.28 77%
Hospital inpatient stays involving opioid-related diagnoses per 100,000 population Fourth quartile (highest income) 177.1 99.4 78%
Hospital admissions for immunization-preventable influenza per 100,000 population, adults age 65 and over Fourth quartile (highest income) 265.7 142.8 86%
Emergency department visits involving opioid-related diagnoses per 100,000 population Fourth quartile (highest income) 162.8 59.2 175%
Hospital admissions with iatrogenic pneumothorax per 1,000 medical and surgical admissions, adults Fourth quartile (highest income) 0.85 0.26 227%
Measures With No Available Benchmark Information
Measure Population Estimate Benchmark Distance to Benchmark
People who were unable to get or delayed in getting needed medical care in the last 12 months High 3.60
People who were unable to get or delayed in getting needed dental care in the last 12 months High 3.70
Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults High 10.00
Hospitalizations and emergency department encounters for congestive heart failure Fourth quartile (highest income) 267.1
Hospital admissions for perforated appendix per 1,000 admissions with appendicitis, adults Fourth quartile (highest income) 392.9
People who were unable to get or delayed in getting needed prescription medicines in the last 12 months High 2.80
People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends High 41.3
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c measurements in the calendar year High 81.3
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year High 69.9
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year High 74.4
People with a usual source of care who is somewhat to very difficulty to contact during regular business hours over the telephone High 14.8
Adults who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist High 13.1
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 High 4.10
Adults age 40 and over with diagnosed diabetes who received a flu vaccination in the calendar year High 65.8
Adults age 40 and over with diabetes whose condition was diagnosed High 79.1
Children who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist High 15.6
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 High 4.80
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 High 5.10
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 High 3.00
Hospital admissions for perforated appendix per 1,000 admissions with appendicitis, children Fourth quartile (highest income) 435.3
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 High 11.5
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 High 3.40
Adults with limited English proficiency and usual source of care (USC) and the USC had language assistance High 82.3
Adults with limited English proficiency who had a usual source of care High 66.9
Hospital admissions for urinary tract infection (UTI) per 100,000 population, children ages 3 months to 17 years Fourth quartile (highest income) 17.7
Adults age 40 and over with diagnosed diabetes with hemoglobin A1c less than 8.0% (optimal control) High 63.6
Adults age 40 and over with diagnosed diabetes with blood pressure less than 130/80 mm Hg High 49.3
Hospital admissions with central venous catheter-related bloodstream infection per 1,000 medical and surgical discharges of length 2 or more days, adults age 18 and over or obstetric admissions Fourth quartile (highest income) 0.64
Hospital admissions for dehydration per 100,000 population, adults age 18 and over Fourth quartile (highest income) 74.0
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 High 7.60
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 High 7.50
Hospital admissions for urinary tract infection (UTI) per 100,000 population, adults age 18 and over Fourth quartile (highest income) 128.4
Postoperative hemorrhage or hematoma with surgical drainage or evacuation per 1,000 surgical hospital discharges, adults Fourth quartile (highest income) 2.01
Postoperative physiologic and metabolic derangements per 1,000 elective surgical hospital discharges, adults Fourth quartile (highest income) 1.27
Postoperative hip fracture per 1,000 surgical admissions who were not susceptible to falling, adults Fourth quartile (highest income) 0.11
Hospital admissions for pediatric gastroenteritis per 100,000 population, children ages 3 months to 17 years Fourth quartile (highest income) 42.7
People age 12 and over who needed treatment for alcohol problem who received such treatment at a specialty facility in the last 12 months High 5.20
Postoperative pulmonary embolism (PE) or deep vein thrombosis (DVT) per 1,000 surgical hospital discharges, adults Fourth quartile (highest income) 8.01
Postoperative respiratory failure per 1,000 elective surgical hospital discharges, adults Fourth quartile (highest income) 4.82
People with a usual source of care who sometimes or never asked person to help make decisions when there was a choice between treatments High 13.7
Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months High 72.0
Children ages 12-17 with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months High 40.7
Reclosure of postoperative abdominal wound dehiscence per 1,000 abdominopelvic-surgery admissions of length 2 or more days, adults Fourth quartile (highest income) 0.81
Adults with hypertension with blood pressure less than 140/90 mm/Hg High 50.1
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms High 70.7
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 High 12.2
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 High 4.20
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, adults Fourth quartile (highest income) 2.13
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, children Fourth quartile (highest income) 0.50
Deaths per 1,000 adult hospital admissions with abdominal aortic aneurysm (AAA) repair Fourth quartile (highest income) 27.6
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 High 9.90
People under age 65 with any period of uninsurance during the year High 10.2
People with a specific source of ongoing care High 92.2
People under age 65 with health insurance High 96.3
Deaths per 1,000 elective-surgery admissions having developed specified complications of care during hospitalization, adults ages 18-89 or obstetric admissions Fourth quartile (highest income) 106.6
People under age 65 with any private health insurance High 91.3
Adults age 65 and over with any private health insurance High 61.8
Deaths per 1,000 hospital admissions with expected low-mortality Fourth quartile (highest income) 0.25
People under age 65 who were uninsured all year High 4.20
People with a usual source of care who usually asks about prescription medications and treatments from other doctors High 82.8
Emergency department visits with a principal diagnosis related to mental health only per 100,000 population Fourth quartile (highest income) 933.3
People with a usual primary care provider High 80.3
People in fair or poor health with a specific source of ongoing care High 94.1
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 High 1.30
Emergency department visits with a principal diagnosis related to substance abuse only, per 100,000 population Fourth quartile (highest income) 560.3
Emergency department encounters for asthma, adults Fourth quartile (highest income) 294.3
Emergency department encounters for asthma, children ages 2-17 Fourth quartile (highest income) 520.8
Adult smokers who attempt to quit in the past year High 55.1
Adolescents females ages 13-15 who received 3 or more doses human papillomavirus vaccine High 35.1
Adolescents females ages 16-17 who received 3 or more doses human papillomavirus vaccine High 52.4
Exclusive breastfeeding through 3 months High 57.4
Adult current smokers with a checkup in the last 12 months who received advice to quit smoking High 63.8
Adults who ever smoked and quitted recently High 9.50
Children with obesity 2-19 years of age who had been told by a doctor or health professional that they were overweight High 55.6
Adults with obesity age 20 and over who had been told by a doctor or health professional that they were overweight High 71.3
Adolescent males ages 16-17 who received 3 or more doses of human papillomavirus (HPV) vaccine High 35.0
Children ages 2-19 with obesity High 11.4
Adults with obesity who ever received advice from a health professional to exercise more High 66.0
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 High 55.4
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 High 50.8
Children ages 6 months to 17 years who received influenza vaccination High 58.2
Children ages 3-5 who ever had their vision checked by a health provider High 69.9
Adults with obesity who ever received advice from a health professional about eating fewer high-fat or high-cholesterol foods High 53.6
Children ages 2-17 for whom a health provider gave advice within the past 2 years about eating healthy High 68.7
Children who had their height and weight measured by a health provider within the past 2 years High 96.3
Children ages 2-17 who had a dental visit in the calendar year High 64.5
Children ages 5-17 with untreated dental caries High 8.80
Children ages 2-17 who had a preventive dental service in the calendar year High 54.8
Adults who received a blood cholesterol measurement in the last 5 years High 89.8
Children 41-80 lbs for whom a health provider gave advice within the past 2 years about using a booster seat when riding in the car High 39.8
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 High 35.6
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 High 65.9
Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high High 95.1
People under age 65 whose family's health insurance premium and out-of-pocket medical expenditures were more than 10% of total family income High 9.20
Adults ages 18-64 at high risk (e.g., COPD) who received an influenza vaccination in the last 12 months High 53.0
Children over 80 lbs for whom a health provider gave advice within the past 2 years about using lap or shoulder belts when riding in a car High 30.6
Adults ages 18 and over who received influenza vaccination High 51.0
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 High 39.1
Children ages 0-17 with wellness checkup in the past 12 months High 88.9
Adults age 65 and over who received an influenza vaccination in the last 12 months High 76.5
Adults who had a preventive dental service in the calendar year High 54.7
People without a usual source of care who indicated a financial or insurance reason for not having a source of care High 5.70
Adults ages 18-64 at high risk (e.g., COPD) who ever received pneumococcal vaccination High 23.2
Adults age 65 and over who ever received pneumococcal vaccination High 67.1
People unable to get or delayed in getting needed medical care due to financial or insurance reasons High 33.5
People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler) High 24.1
Adults with a dental visit in the calendar year High 47.6
People unable to get or delayed in getting needed dental care due to financial or insurance reasons High 61.6
People unable to get or delayed in getting needed prescription medicines due to financial or insurance reasons High 49.3