NationalLow Income Quality Measures Compared to Achievable Benchmarks

The NHQR quality measures specific to Low 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
Obstetric trauma per 1,000 vaginal deliveries without instrument assistance Negative/poor 14.2 15.1 Achieved: 6% 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) Negative/poor 94.4 96.7 2%
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined Negative/poor 91.2 94.4 3%
Obstetric trauma per 1,000 instrument-assisted deliveries Negative/poor 99.6 95.2 5%
Children ages 19-35 months who received 3 or more doses of hepatitis B vaccine Negative/poor 91.5 96.3 5%
Children ages 19-35 months who received 1 or more doses of varicella vaccine Negative/poor 89.9 94.9 5%
Children ages 19-35 months who received 3 or more doses of polio vaccine Negative/poor 92.2 97.3 5%
Children ages 19-35 months who received 1 or more doses of measles-mumps-rubella vaccine Negative/poor 89.6 95.9 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 Negative/poor 86.7 95.3 9%
Adolescent aged 13-15 years who received 3 or more doses of human papillomavirus (HPV) vaccine Negative/poor 33.1 36.7 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 Negative/poor 84.2 93.5 10%
Measures That Are Close to Benchmark
Measure Population Estimate Benchmark Distance to Benchmark
Children ages 19-35 months who received 4 or more doses of diphtheria-tetanus-pertussis vaccine Negative/poor 79.5 90.2 12%
Persons aged 16 to 17 years who received 1 or more doses of meningococcal conjugate vaccine Negative/poor 79.4 94.8 16%
Persons aged 13 to 15 years who received 1 or more doses of meningococcal conjugate vaccine Negative/poor 79.2 95.5 17%
Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis Negative/poor 79.9 96.6 17%
Adolescent ages 16-17 years who received 3 or more doses of human papillomavirus (HPV) vaccine Negative/poor 40.0 50.9 21%
Deaths per 1,000 adult hospital admissions with acute myocardial infarction (AMI) Negative/poor 44.8 36.8 22%
Birth trauma - injury to neonate per 1,000 selected live births Negative/poor 1.80 1.38 30%
Deaths per 1,000 adult hospital admissions with congestive heart failure Negative/poor 16.3 12.3 32%
Deaths per 1,000 hospital admissions with percutaneous transluminal coronary angioplasty (PTCA), age 40 and over Negative/poor 16.2 12.1 34%
Deaths per 1,000 adult hospital admissions with pneumonia Negative/poor 20.3 14.8 37%
Deaths per 1,000 hospital admissions with coronary artery bypass surgery, age 40 and over Negative/poor 20.5 14.4 42%
Postoperative sepsis per 1,000 elective-surgery admissions of length 4 or more days, adults Negative/poor 18.3 12.2 50%
Measures That Are Far From Benchmark
Measure Population Estimate Benchmark Distance to Benchmark
Hospital admissions for short-term complications of diabetes per 100,000 population, ages 6-17 Negative/poor 33.3 16.3 105%
Avoidable admissions for bacterial pneumonia per 100,000 population age 18 and over Negative/poor 347.0 160.3 117%
Hospital admissions for congestive heart failure per 100,000 population Negative/poor 468.9 198.8 136%
Hospital admissions for short-term complications of diabetes per 100,000 population, adults Negative/poor 132.2 52.3 153%
Hospital admissions for immunization-preventable influenza per 100,000 population age 65 and over Negative/poor 163.5 56.2 191%
Hospital admissions for asthma per 100,000 population, age 18 to 39 Negative/poor 74.1 24.1 208%
Avoidable admissions for chronic obstructive pulmonary disease or asthma per 100,000 population age 40 and over Negative/poor 691.4 218.6 216%
Hospital admissions with iatrogenic pneumothorax per 1,000 medical and surgical admissions, adults Negative/poor 0.92 0.29 221%
Hospital admissions for lower extremity amputations per 1,000 population age 18 and over with diabetes, HCUP data Negative/poor 31.5 9.70 225%
Hospital admissions for asthma per 100,000 population, ages 2-17 Negative/poor 165.9 47.7 248%
Hospital admissions for long-term complications of diabetes per 100,000 population, adults Negative/poor 187.5 52.6 256%
Avoidable admissions for angina per 100,000 population age 18 and over Negative/poor 18.1 5.05 258%
Avoidable admissions for hypertension per 100,000 population age 18 and over Negative/poor 90.4 20.4 344%
Hospital admissions for uncontrolled diabetes without complications per 100,000 population, adults, HCUP data Negative/poor 25.6 4.10 524%
Measures With No Available Benchmark Information
Measure Population 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 Negative/poor 18.4
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 Negative/poor 0.72
Postoperative hemorrhage or hematoma with surgical drainage or evacuation per 1,000 surgical hospital discharges, adults Negative/poor 2.35
Postoperative pulmonary embolism (PE) or deep vein thrombosis (DVT) per 1,000 surgical hospital discharges, adults Negative/poor 8.22
Postoperative respiratory failure per 1,000 elective surgical hospital discharges, adults Negative/poor 6.53
Postoperative physiologic and metabolic derangements per 1,000 elective surgical hospital discharges, adults Negative/poor 2.10
Postoperative hip fracture per 1,000 surgical admissions who were not susceptible to falling, adults Negative/poor 0.13
Reclosure of postoperative abdominal wound dehiscence per 1,000 abdominopelvic-surgery admissions of length 2 or more days, adults Negative/poor 1.37
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 Negative/poor 18.1
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 Negative/poor 6.60
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 Negative/poor 7.50
People under age 65 with health insurance Negative/poor 77.0
People under age 65 with any private health insurance Negative/poor 17.4
Adults age 65 and over with any private health insurance Negative/poor 18.2
People under age 65 who were uninsured all year Negative/poor 19.1
People under age 65 with any period of uninsurance during the year Negative/poor 37.1
People with a specific source of ongoing care Negative/poor 80.9
People with a usual primary care provider Negative/poor 72.5
People in fair or poor health with a specific source of ongoing care Negative/poor 85.8
People who were unable to get or delayed in getting needed medical care in the last 12 months Negative/poor 6.60
People who were unable to get or delayed in getting needed dental care in the last 12 months Negative/poor 8.70
People who were unable to get or delayed in getting needed prescription medicines in the last 12 months Negative/poor 4.80
People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends Negative/poor 39.5
People with a usual source of care who is somewhat to very difficulty to contact during regular business hours over the telephone Negative/poor 18.0
Adults who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist Negative/poor 25.7
Children who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist Negative/poor 22.1
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 Negative/poor 14.9
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, children Negative/poor 0.53
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 Negative/poor 10.6
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 Negative/poor 7.40
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 Negative/poor 8.10
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 Negative/poor 13.4
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 Negative/poor 7.30
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, adults Negative/poor 2.63
Deaths per 1,000 elective-surgery admissions having developed specified complications of care during hospitalization, ages 18-89 or obstetric admissions Negative/poor 116.4
Deaths per 1,000 hospital admissions with expected low-mortality Negative/poor 0.35
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 Negative/poor 2.20
Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults Negative/poor 13.6
Adults with limited English proficiency who had a usual source of care Negative/poor 57.9
People with a usual source of care who sometimes or never asked person to help make decisions when there was a choice between treatments Negative/poor 18.8
Potentially avoidable hospitalizations and emergency department encounters for congestive heart failure First quartile (lowest income) 567.4
Hospital admissions for perforated appendix per 1,000 admissions with appendicitis, adults Negative/poor 360.7
Hospital admissions for perforated appendix per 1,000 admissions with appendicitis, children Negative/poor 445.2
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 Negative/poor 18.8
Adults with limited English proficiency and usual source of care (USC) by whether the USC had language assistance Negative/poor 94.6
Emergency department visits with a principal diagnosis related to co-occurring of mental health, alcohol and substance abuse, per 100,000 population First quartile (lowest income) 58.0
Potentially avoidable emergency department encounters for asthma, adults First quartile (lowest income) 922.8
Potentially avoidable emergency department encounters for asthma, children ages 2-17 First quartile (lowest income) 1514.8
People with a usual source of care who usually asks about prescription medications and treatments from other doctors Negative/poor 77.2
Emergency department visits with a principal diagnosis related to mental health only per 100,000 population First quartile (lowest income) 1993.0
Emergency department visits with a principal diagnosis related to substance abuse only, per 100,000 population First quartile (lowest income) 860.0
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c measurements in the calendar year Negative/poor 71.7
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year Negative/poor 54.8
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year Negative/poor 70.5
Adults age 40 and over with diagnosed diabetes who received a flu vaccination in the calendar year Negative/poor 63.2
Adults age 40 and over with diabetes whose condition was diagnosed Negative/poor 77.7
Admissions for dehydration per 100,000 population, age 18 and over Negative/poor 128.4
Admissions for urinary tract infection (UTI) per 100,000 population, age 18 and over Negative/poor 223.4
Admissions for urinary tract infection (UTI) per 100,000 population, ages 3 months to 17 years Negative/poor 38.3
Admissions for pediatric gastroenteritis per 100,000 population, ages 3 months to 17 years Negative/poor 48.1
Adults with hypertension with blood pressure less than 140/90 mm/Hg Negative/poor 45.0
Deaths per 1,000 adult hospital admissions with abdominal aortic aneurysm (AAA) repair Negative/poor 29.4
Children with obesity 2-19 years of age who had been told by a doctor or health professional that they were overweight Negative/poor 48.5
Adults with obesity age 20 and over who had been told by a doctor or health professional that they were overweight Negative/poor 65.2
Children ages 2-5 with obesity Negative/poor 11.6
Children ages 6-11 with obesity Negative/poor 21.5
Children ages 12-19 with obesity Negative/poor 22.4
Adults with obesity who ever received advice from a health professional to exercise more Negative/poor 61.0
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 Negative/poor 60.3
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 Negative/poor 41.0
Adults with obesity who ever received advice from a health professional about eating fewer high-fat or high-cholesterol foods Negative/poor 47.1
Children ages 2-17 for whom a health provider gave advice within the past 2 years about eating healthy Negative/poor 59.8
Adults age 40 and over with diagnosed diabetes with hemoglobin A1c less than 8.0% (optimal control) Negative/poor 67.3
Adults age 40 and over with diagnosed diabetes with blood pressure less than 130/80 mm Hg Negative/poor 45.6
Adult current smokers with a checkup in the last 12 months who received advice to quit smoking Negative/poor 68.2
Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months Negative/poor 66.7
Children ages 12-17 with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months Negative/poor 40.4
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 Negative/poor 22.0
People age 12 and over who needed treatment for alcohol problem who received such treatment at a specialty facility in the last 12 months Negative/poor 15.1
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms Negative/poor 72.5
People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler) Negative/poor 21.6
Persons with current asthma who received written asthma management plans from their healthcare provider Negative/poor 41.5
Persons with current asthma who received education about appropriate response to an asthma episode Negative/poor 64.0
Persons with current asthma who were advised to change things to reduce exposure to irritants Negative/poor 47.0
Women ages 50-74 who received a mammogram in the last 2 years Negative/poor 57.0
Women ages 21-65 who received a Pap smear in the last 3 years Negative/poor 66.6
Adolescents females ages 13-15 who received 3 or more doses human papillomavirus vaccine Negative/poor 38.9
Adults ages 18-64 at high risk (e.g., COPD) who ever received pneumococcal vaccination Negative/poor 22.1
Children ages 2-17 who had a dental visit in the calendar year Negative/poor 45.9
Adolescents females ages 16-17 who received 3 or more doses human papillomavirus vaccine Negative/poor 51.3
Children ages 12-17 with untreated dental caries Negative/poor 26.6
Children ages 5-11 with untreated dental caries Negative/poor 23.2
People without a usual source of care who indicated a financial or insurance reason for not having a source of care Negative/poor 32.4
Children ages 0-17 with wellness checkup in the past 12 months Negative/poor 81.0
People unable to get or delayed in getting needed medical care due to financial or insurance reasons Negative/poor 66.1
Adults ages 18-64 at high risk (e.g., COPD) who received an influenza vaccination in the last 12 months Negative/poor 40.7
Adults age 65 and over who ever received pneumococcal vaccination Negative/poor 47.3
Children ages 5-17 with untreated dental caries Negative/poor 24.6
Children ages 3-5 who ever had their vision checked by a health provider Negative/poor 64.4
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 Negative/poor 58.5
People unable to get or delayed in getting needed dental care due to financial or insurance reasons Negative/poor 74.9
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 Negative/poor 63.8
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 Negative/poor 43.5
People unable to get or delayed in getting needed prescription medicines due to financial or insurance reasons Negative/poor 71.8
Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high Negative/poor 86.2
Adolescent males ages 13-15 years who received 3 or more doses of human papillomavirus (HPV) vaccine Negative/poor 27.3
Adolescent males ages 16-17 years who received 3 or more doses of human papillomavirus (HPV) vaccine Negative/poor 26.9
Adults who received a blood cholesterol measurement in the last 5 years Negative/poor 79.7
People under age 65 whose family's health insurance premium and out-of-pocket medical expenditures were more than 10% of total family income Negative/poor 24.5
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 Negative/poor 33.5
Adults ages 18 and over who received influenza vaccination Negative/poor 33.7
Adults age 65 and over who received an influenza vaccination in the last 12 months Negative/poor 69.3
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 Negative/poor 35.3
Children ages 6 months to 17 years who received influenza vaccination Negative/poor 56.6
Children who had their height and weight measured by a health provider within the past 2 years Negative/poor 90.1