NationalResidents of Rural Areas Quality Measures Compared to Achievable Benchmarks

The NHQR quality measures specific to Residents of Rural Areas 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:

Measures That Achieved Benchmark or Better

Measure	Population	Estimate	Benchmark	Distance to Benchmark
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)	Noncore	94.8	96.8	2%
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined	Noncore	89.9	95.9	6%

Measures That Are Close to Benchmark

Measure	Population	Estimate	Benchmark	Distance to Benchmark
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	Nonmetropolitan	84.0	95.2	12%
Women ages 21-65 who received a Pap smear in the last 3 years	Noncore (nonmetropolitan)	74.0	86.9	15%
Obstetric trauma per 1,000 instrument-assisted deliveries	Noncore	108.9	94.3	15%
Breast cancer deaths per 100,000 female population per year	Noncore	20.6	17.8	16%
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	Nonmetropolitan	80.7	95.9	16%
Deaths per 1,000 hospital admissions with percutaneous transluminal coronary angioplasty (PTCA), adults age 40 and over	Noncore	13.7	11.4	20%
Obstetric trauma per 1,000 vaginal deliveries without instrument assistance	Noncore	17.6	14.1	24%
Adolescents ages 16-17 who received 1 or more doses of meningococcal conjugate vaccine	Nonmetropolitan	72.4	96.2	25%
Adolescents ages 13-15 who received 1 or more doses of meningococcal conjugate vaccine	Nonmetropolitan	71.1	95.4	25%
Women ages 50-74 who received a mammogram in the last 2 years	Noncore (nonmetropolitan)	60.3	85.2	29%
Birth trauma - injury to neonate per 1,000 selected live births	Noncore	1.70	1.29	32%
Hospital admissions for asthma per 100,000 population, children ages 2-17	Noncore	53.5	38.1	40%
Adolescent aged 13-15 years who received 3 or more doses of human papillomavirus (HPV) vaccine	Nonmetropolitan	27.3	46.4	41%
Deaths per 1,000 hospital admissions with coronary artery bypass surgery, adults age 40 and over	Noncore	19.8	13.6	46%
Sepsis diagnoses per 1,000 elective-surgery admissions of length 4 or more days, adults	Noncore	15.2	10.4	46%
HIV infection deaths per 100,000 population	Noncore	1.10	0.75	47%
Colorectal cancer deaths per 100,000 population per year	Noncore	17.1	11.5	48%
Adolescent males ages 13-15 who received 3 or more doses of human papillomavirus (HPV) vaccine	Nonmetropolitan	22.3	43.3	48%
Adolescent ages 16-17 years who received 3 or more doses of human papillomavirus (HPV) vaccine	Nonmetropolitan	31.7	62.2	49%

Measures That Are Far From Benchmark

Measure	Population	Estimate	Benchmark	Distance to Benchmark
Hospital admissions for asthma per 100,000 population, adults ages 18-39	Noncore	35.4	20.4	74%
Hospital admissions for short-term complications of diabetes per 100,000 population, adults	Noncore	100.1	56.8	76%
Hospital admissions with iatrogenic pneumothorax per 1,000 medical and surgical admissions, adults	Noncore	0.46	0.26	77%
Deaths per 1,000 adult hospital admissions with acute myocardial infarction (AMI)	Noncore	63.0	35.5	77%
Lung cancer deaths per 100,000 population per year	Noncore	49.8	27.5	81%
Hospital admissions for congestive heart failure per 100,000 population	Noncore	368.0	202.0	82%
Hospital admissions for immunization-preventable influenza per 100,000 population, adults age 65 and over	Noncore	280.7	142.8	97%
Hospital admissions for long-term complications of diabetes per 100,000 population, adults	Noncore	108.6	54.8	98%
Hospital admissions for short-term complications of diabetes per 100,000 population, children ages 6-17	Noncore	28.7	13.6	111%
Hospital admissions for hypertension per 100,000 population, adults age 18 and over	Noncore	45.4	20.4	123%
Hospital inpatient stays involving opioid-related diagnoses per 100,000 population	Noncore	225.5	99.4	127%
Hospital admissions for lower extremity amputations per 1,000 population, adults age 18 and over with diabetes	Noncore	20.9	9.03	131%
Deaths per 1,000 adult hospital admissions with pneumonia	Noncore	29.7	12.8	132%
Suicide deaths among persons age 12 and over per 100,000 population	Noncore	22.7	9.38	142%
Deaths per 1,000 adult hospital admissions with congestive heart failure	Noncore	28.3	11.5	146%
Hospital admissions for chronic obstructive pulmonary disease or asthma per 100,000 population, adults age 40 and over	Noncore	586.5	216.7	171%
Hospital admissions for angina per 100,000 population, adults age 18 and over	Noncore	13.3	4.90	171%
Hospital admissions for bacterial pneumonia per 100,000 population, adults age 18 and over	Noncore	460.4	161.5	185%
Emergency department visits involving opioid-related diagnoses per 100,000 population	Noncore	183.9	59.2	211%
Hospital admissions for uncontrolled diabetes without complications per 100,000 population, adults	Noncore	16.5	3.28	403%

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	Noncore	4.90
People who were unable to get or delayed in getting needed dental care in the last 12 months	Noncore	4.20
Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults	Noncore	15.4
Hospitalizations and emergency department encounters for congestive heart failure	Noncore	467.9
Hospital admissions for perforated appendix per 1,000 admissions with appendicitis, adults	Noncore	411.9
People who were unable to get or delayed in getting needed prescription medicines in the last 12 months	Noncore	3.80
People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends	Noncore	28.8
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c measurements in the calendar year	Nonmetropolitan	77.6
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year	Noncore	62.5
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year	Noncore	68.2
People with a usual source of care who is somewhat to very difficulty to contact during regular business hours over the telephone	Noncore	17.1
Adults who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist	Noncore	22.0
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	Noncore	7.70
Adults age 40 and over with diagnosed diabetes who received a flu vaccination in the calendar year	Noncore	56.9
Children who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist	Nonmetropolitan	17.5
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	Noncore	8.10
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	Nonmetropolitan	7.30
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	Noncore	5.10
Hospital admissions for perforated appendix per 1,000 admissions with appendicitis, children	Noncore	462.2
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	Noncore	26.8
Adults with limited English proficiency and usual source of care (USC) and the USC had language assistance	Nonmetropolitan	91.3
Adults with limited English proficiency who had a usual source of care	Noncore	65.1
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	Noncore	0.29
Hospital admissions for dehydration per 100,000 population, adults age 18 and over	Noncore	128.9
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	Noncore	12.2
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	Noncore	17.1
Hospital admissions for urinary tract infection (UTI) per 100,000 population, adults age 18 and over	Noncore	219.7
Postoperative hemorrhage or hematoma with surgical drainage or evacuation per 1,000 surgical hospital discharges, adults	Noncore	1.85
Postoperative physiologic and metabolic derangements per 1,000 elective surgical hospital discharges, adults	Noncore	0.96
Postoperative hip fracture per 1,000 surgical admissions who were not susceptible to falling, adults	Noncore	0.17
Hospital admissions for urinary tract infection (UTI) per 100,000 population, children ages 3 months to 17 years	Noncore	36.4
Hospital admissions for pediatric gastroenteritis per 100,000 population, children ages 3 months to 17 years	Noncore	53.7
People age 12 and over who needed treatment for alcohol problem who received such treatment at a specialty facility in the last 12 months	Noncore	11.1
Postoperative pulmonary embolism (PE) or deep vein thrombosis (DVT) per 1,000 surgical hospital discharges, adults	Noncore	6.09
Postoperative respiratory failure per 1,000 elective surgical hospital discharges, adults	Noncore	4.53
People with a usual source of care who sometimes or never asked person to help make decisions when there was a choice between treatments	Noncore	16.4
Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months	Noncore	69.0
Children ages 12-17 with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months	Noncore	38.2
Reclosure of postoperative abdominal wound dehiscence per 1,000 abdominopelvic-surgery admissions of length 2 or more days, adults	Noncore	2.18
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms	Noncore (nonmetropolitan)	70.1
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 needed	Noncore	9.10
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	Noncore	18.6
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	Nonmetropolitan	3.80
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, adults	Noncore	2.68
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, children	Noncore	0.60
Deaths per 1,000 adult hospital admissions with abdominal aortic aneurysm (AAA) repair	Noncore	26.1
People under age 65 with any period of uninsurance during the year	Noncore	27.9
People with a specific source of ongoing care	Noncore (nonmetropolitan)	90.1
People under age 65 with health insurance	Noncore (nonmetropolitan)	87.2
Deaths per 1,000 elective-surgery admissions having developed specified complications of care during hospitalization, adults ages 18-89 or obstetric admissions	Noncore	77.6
People under age 65 with any private health insurance	Noncore (nonmetropolitan)	58.2
Adults age 65 and over with any private health insurance	Noncore (nonmetropolitan)	50.7
Deaths per 1,000 hospital admissions with expected low-mortality	Noncore	0.35
People under age 65 who were uninsured all year	Noncore	12.0
People with a usual source of care who usually asks about prescription medications and treatments from other doctors	Noncore	80.3
Emergency department visits with a principal diagnosis related to mental health only per 100,000 population	Noncore	1279.1
People with a usual primary care provider	Noncore	81.8
People in fair or poor health with a specific source of ongoing care	Noncore (nonmetropolitan)	91.7
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	Nonmetropolitan	1.90
Emergency department visits with a principal diagnosis related to substance abuse only, per 100,000 population	Noncore	470.7
Emergency department encounters for asthma, adults	Noncore	529.1
Emergency department encounters for asthma, children ages 2-17	Noncore	710.5
Children ages 2-19 who visited emergency department for asthma	Nonmetropolitan	73.7
Adult current smokers with a checkup in the last 12 months who received advice to quit smoking	Noncore	59.7
Adolescents females ages 13-15 who received 3 or more doses human papillomavirus vaccine	Nonmetropolitan	32.9
Adolescents females ages 16-17 who received 3 or more doses human papillomavirus vaccine	Nonmetropolitan	40.0
Exclusive breastfeeding through 3 months	Nonmetropolitan	45.2
Adolescent males ages 16-17 who received 3 or more doses of human papillomavirus (HPV) vaccine	Nonmetropolitan	22.7
Adults with obesity who ever received advice from a health professional to exercise more	Noncore	56.8
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	Noncore	54.1
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	Noncore	48.0
Children ages 3-5 who ever had their vision checked by a health provider	Nonmetropolitan	59.9
Adults with obesity who ever received advice from a health professional about eating fewer high-fat or high-cholesterol foods	Noncore	47.6
Children ages 2-17 for whom a health provider gave advice within the past 2 years about eating healthy	Noncore	55.4
Children who had their height and weight measured by a health provider within the past 2 years	Noncore	92.0
Children ages 2-17 who had a dental visit in the calendar year	Noncore	50.9
Children ages 2-17 who had a preventive dental service in the calendar year	Noncore	44.6
Adults who received a blood cholesterol measurement in the last 5 years	Noncore (nonmetropolitan)	80.1
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	Noncore	33.2
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	Noncore	42.8
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	Nonmetropolitan	71.9
Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high	Noncore (nonmetropolitan)	92.2
People under age 65 whose family's health insurance premium and out-of-pocket medical expenditures were more than 10% of total family income	Noncore	23.5
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	Nonmetropolitan	24.0
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	Noncore	31.0
Children ages 0-17 with wellness checkup in the past 12 months	Noncore (nonmetropolitan)	77.9
Adults who had a preventive dental service in the calendar year	Noncore	32.7
People without a usual source of care who indicated a financial or insurance reason for not having a source of care	Nonmetropolitan	8.30
People unable to get or delayed in getting needed medical care due to financial or insurance reasons	Nonmetropolitan	52.8
People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler)	Noncore	19.2
Adults with a dental visit in the calendar year	Noncore	24.4
People unable to get or delayed in getting needed dental care due to financial or insurance reasons	Nonmetropolitan	79.3
People unable to get or delayed in getting needed prescription medicines due to financial or insurance reasons	Nonmetropolitan	56.6
Live-born infants with low birth weight (less than 2,500 g)	Noncore	8.10
Infant mortality per 1,000 live births, birth weight 2,500 grams or more	Noncore	2.90
Infant mortality per 1,000 live births, birth weight less than 1,500 grams	Noncore	224.7
Infant mortality per 1,000 live births, birth weights 1,500-2,499 grams	Noncore	13.7