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NationalResidents of Rural Areas Quality Measures Compared to Achievable Benchmarks
The NHQDR 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:
| Measure | Population | Estimate | Benchmark | Distance to Benchmark |
|---|---|---|---|---|
| Hospital admissions for perforated appendix per 1,000 admissions with appendicitis, adults | Noncore | 541.0 | ||
| Hospital admissions for perforated appendix per 1,000 admissions with appendicitis, children | Noncore | 556.4 | ||
| People under age 65 who were uninsured all year | Noncore | 10.6 | ||
| People under age 65 with any period of uninsurance during the year | Noncore | 24.1 | ||
| People under age 65 without health insurance | Micropolitan (nonmetro) | 14.0 | ||
| Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, adults | Noncore | 1.1 | ||
| Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, children | Noncore | 0.3 | ||
| Adults who had a doctor's office or clinic visit in the last 12 months whose health providers always gave them easy-to-understand instructions about what to do for a specific illness or health conditions | Noncore | 67.0 | ||
| Adults with limited English proficiency who had a usual source of care | Nonmetropolitan | 69.1 | ||
| 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 | Noncore | 15.0 | ||
| People under age 65 with public health insurance only | Micropolitan (nonmetro) | 27.3 | ||
| People under age 65 with any period of public insurance during the year | Noncore | 39.6 | ||
| People with a specific source of ongoing care | Micropolitan (nonmetro) | 89.1 | ||
| Hospital admissions for hypertension per 100,000 population, adults age 18 and over | Noncore | 47.1 | ||
| Hospital admissions for dehydration per 100,000 population, adults age 18 and over | Noncore | 213.4 | ||
| People with a usual primary care provider | Noncore | 83.0 | ||
| People in fair or poor health with a specific source of ongoing care | Micropolitan (nonmetro) | 89.1 | ||
| Deaths per 1,000 hospital admissions with expected low-mortality | Noncore | 0.4 | ||
| In-hospital deaths per 100,000 delivery hospitalizations, women ages 12-55 | Noncore | 5.8 | ||
| Hospital admissions with iatrogenic pneumothorax per 1,000 medical and surgical admissions, adults | Noncore | 0.2 | ||
| Deaths per 1,000 elective-surgery admissions having developed specified complications of care during hospitalization, adults ages 18-89 or obstetric admissions | Noncore | 147.7 | ||
| Adults who had a doctor's office or clinic visit in the last 12 months whose health providers always asked them to describe how they will follow the instructions | Noncore | 28.9 | ||
| Adults who had a doctor's office or clinic visit in the last 12 months whose health providers always offered help in filling out forms | Noncore | 18.5 | ||
| Hospital admissions for urinary tract infection (UTI) per 100,000 population, children ages 3 months to 17 years | Noncore | 28.4 | ||
| Hospital admissions for pediatric gastroenteritis per 100,000 population, children ages 3 months to 17 years | Noncore | 30.1 | ||
| People who were unable to get or delayed in getting needed medical care in the last 12 months | Noncore | 5.1 | ||
| People who were unable to get or delayed in getting needed dental care in the last 12 months | Noncore | 3.4 | ||
| Hospital admissions for chronic obstructive pulmonary disease or asthma per 100,000 population, adults age 40 and over | Noncore | 676.4 | ||
| Hospital admissions for community-acquired pneumonia per 100,000 population, adults age 18 and over | Noncore | 481.9 | ||
| Hospital admissions for urinary tract infection (UTI) per 100,000 population, adults age 18 and over | Noncore | 247.8 | ||
| People who identified a hospital, emergency room, or clinic as a source of ongoing care | Micropolitan (nonmetro) | 33.2 | ||
| Composite measure: People who were unable to get or delayed in getting needed medical care, dental care, or prescription medicines in the last 12 months | Noncore | 9.4 | ||
| Tamoxifen or third generation aromatase inhibitor was recommended or administered within 1 year of diagnosis for women with AJCC T1cN0M0 or stage IB to stage III hormone receptor-positive breast cancer | Noncore | 88.9 | ||
| People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends | Noncore | 30.8 | ||
| People with a usual source of care who is somewhat to very difficulty to contact during regular business hours over the telephone | Noncore | 14.1 | ||
| Obstetric trauma per 1,000 instrument-assisted deliveries | Noncore | 88.6 | ||
| Venous thromboembolism or pulmonary embolism per 1,000 delivery discharges, women ages 12-55 | Noncore | 0.3 | ||
| People who were unable to get or delayed in getting needed prescription medicines in the last 12 months | Noncore | 2.8 | ||
| Birth trauma - injury to neonate per 1,000 selected live births | Noncore | 5.5 | ||
| Obstetric trauma per 1,000 vaginal deliveries without instrument assistance | Noncore | 14.5 | ||
| Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults | Noncore | 11.3 | ||
| Radiation therapy was recommended or administered following any mastectomy within 1 year of diagnosis of breast cancer for women with 4 positive regional lymph nodes | Noncore | 88.5 | ||
| 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 | 6.2 | ||
| Radiation therapy was completed within 60 days of initiation of radiation among women diagnosed with any stage of cervical cancer | Noncore | 86.4 | ||
| Use of brachytherapy in patients treated with primary radiation with curative intent in any stage of cervical cancer | Noncore | 73.0 | ||
| Adults who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist | Noncore | 16.4 | ||
| Children who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist | Nonmetropolitan | 25.7 | ||
| People with a usual source of care who usually asks about prescription medications and treatments from other doctors | Noncore | 79.6 | ||
| Emergency department visits with a principal diagnosis related to mental health only per 100,000 population | Noncore | 1076.6 | ||
| Emergency department visits with a principal diagnosis related to substance abuse only, per 100,000 population | Noncore | 343.7 | ||
| 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 | Noncore | 9.4 | ||
| 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 | 4.3 | ||
| 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 | Noncore | 0.1 | ||
| Combination chemotherapy was recommended or administered within 4 months of diagnosis for women under 70 with AJCC T1cN0MO or Stage IB-III hormone receptor negative breast cancer | Noncore | 90.8 | ||
| Sepsis diagnoses per 1,000 elective-surgery admissions of length 4 or more days, adults | Noncore | 4.4 | ||
| Postoperative hemorrhage or hematoma with surgical drainage or evacuation per 1,000 surgical hospital discharges, adults | Noncore | 2.4 | ||
| Children ages 2-19 who visited emergency department for asthma | Non-MSA | 79.3 | ||
| Hospital admissions for uncontrolled diabetes without complications per 100,000 population, adults | Noncore | 51.7 | ||
| Emergency department visits triaged as urgent at which patients waited to see a physician for one hour or more per 10,000 population | Non-MSA | 12.5 | ||
| Postoperative pulmonary embolism (PE) or deep vein thrombosis (DVT) per 1,000 surgical hospital discharges, adults | Noncore | 3.3 | ||
| Composite measure: Emergency department visits with a principal diagnosis related to co-occurring of mental health, alcohol and substance abuse, per 100,000 population | Noncore | 303.5 | ||
| Emergency department visits with a principal diagnosis related to dental conditions | Micropolitan and noncore (rural) | 482.9 | ||
| Emergency department encounters for asthma, adults | Noncore | 377.5 | ||
| Emergency department encounters for asthma, children ages 2-17 | Noncore | 492.2 | ||
| 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 | 11.2 | ||
| 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 | Noncore | 7.3 | ||
| Hospital admissions for short-term complications of diabetes per 100,000 population, adults | Noncore | 58.2 | ||
| Postoperative hip fracture per 1,000 surgical admissions who were not susceptible to falling, adults | Noncore | 0.1 | ||
| 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 | 4.8 | ||
| Hospital admissions for long-term complications of diabetes per 100,000 population, adults | Noncore | 89.6 | ||
| Hospital admissions for lower extremity amputations per 1,000 population, adults age 18 and over with diabetes | Noncore | 30.9 | ||
| Hospital admissions for asthma per 100,000 population, adults ages 18-39 | Noncore | 26.2 | ||
| Reclosure of postoperative abdominal wound dehiscence per 1,000 abdominopelvic-surgery admissions of length 2 or more days, adults | Noncore | 1.0 | ||
| Hospital admissions for short-term complications of diabetes per 100,000 population, children ages 6-17 | Noncore | 26.9 | ||
| Postoperative physiologic and metabolic derangements per 1,000 elective surgical hospital discharges, adults | Noncore | 0.9 | ||
| Postoperative respiratory failure per 1,000 elective surgical hospital discharges, adults | Noncore | 6.4 | ||
| Composite measure: Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never listened carefully, explained things clearly, respected what they had to say, and spent enough time with them | Noncore | 6.4 | ||
| People under age 65 with any private health insurance | Micropolitan (nonmetro) | 58.5 | ||
| Adults age 65 and over with any private health insurance | Micropolitan (nonmetro) | 53.5 | ||
| 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 | 12.0 | ||
| Adults with limited English proficiency and usual source of care (USC) and the USC had language assistance | Nonmetropolitan | 94.0 | ||
| Adults with obesity | Noncore | 37.8 | ||
| Adults who do not now spend half an hour or more in moderate or vigorous physical activity at least five times a week | Noncore | 48.4 | ||
| 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 | 6.3 | ||
| 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 | 7.2 | ||
| Hospital admissions for asthma per 100,000 population, children ages 2-17 | Noncore | 48.0 | ||
| Hospitalizations and emergency department encounters for congestive heart failure | Noncore | 663.8 | ||
| People under age 65 with health insurance | Micropolitan (nonmetro) | 86.0 | ||
| Deaths per 1,000 hospital admissions with percutaneous transluminal coronary angioplasty (PTCA), adults age 40 and over | Noncore | 27.5 | ||
| 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 | 12.0 | ||
| Adults who filled four or more outpatient opioid prescriptions in the calendar year | Noncore | 7.3 | ||
| Adults with opioid (either prescription opioid or heroin) use disorder in the past year | Nonmetropolitan | 0.8 | ||
| Adolescent males ages 16-17 who received 3 or more doses of human papillomavirus (HPV) vaccine | Nonmetropolitan | 26.6 | ||
| Adults who filled an outpatient opioid prescription in the calendar year | Noncore | 17.8 | ||
| Adolescents females ages 16-17 who received 3 or more doses human papillomavirus vaccine | Nonmetropolitan | 37.4 | ||
| Adolescents females ages 13-15 who received 3 or more doses human papillomavirus vaccine | Nonmetropolitan | 31.8 | ||
| Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms | Micropolitan (nonmetro) | 68.1 | ||
| Adolescent aged 13-15 years who received 3 or more doses of human papillomavirus (HPV) vaccine | Nonmetropolitan | 26.2 | ||
| Adolescent ages 16-17 years who received 3 or more doses of human papillomavirus (HPV) vaccine | Nonmetropolitan | 32.0 | ||
| Adolescents ages 13-15 years (excluding adolescents who have had varicella) vaccinated with at least 2 doses of varicella | Nonmetropolitan | 85.5 | ||
| Adolescents ages 16-17 years (excluding adolescents who have had varicella) vaccinated with at least 2 doses of varicella | Nonmetropolitan | 75.5 | ||
| Children who had their height and weight measured by a health provider within the past 2 years | Noncore | 91.8 | ||
| People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler) | Noncore | 16.1 | ||
| Composite measure: Adults age 40 and over with diagnosed diabetes who received all four recommended services for diabetes in the calendar year (two or more hemoglobin A1c measurement, dilated eye examination, foot examination, and flu vaccination) | Nonmetropolitan | 23.9 | ||
| Deaths per 1,000 adult hospital admissions with pneumonia | Noncore | 30.6 | ||
| Composite measure: Adults ages 50-75 who received any type of colorectal cancer screening | Micropolitan (nonmetro) | 59.8 | ||
| Children ages 2-17 who had a dental visit in the calendar year | Noncore | 49.6 | ||
| Children ages 2-17 who received a preventive dental service in the calendar year | Noncore | 38.1 | ||
| 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 | 64.6 | ||
| 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 | 24.1 | ||
| Children ages 3-5 who ever had their vision checked by a health provider | Nonmetropolitan | 61.1 | ||
| Infant mortality per 1,000 live births, birth weight less than 1,500 grams | Noncore | 210.7 | ||
| Infant mortality per 1,000 live births, birth weights 1,500-2,499 grams | Noncore | 17.2 | ||
| 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 | 30.6 | ||
| 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 | 24.2 | ||
| Infant mortality per 1,000 live births, birth weight 2,500 grams or more | Noncore | 3.1 | ||
| Composite measures: Infant mortality per 1,000 live births, all birth weights | Noncore | 6.9 | ||
| 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 | 41.2 | ||
| People with current asthma | Noncore | 8.4 | ||
| Live-born infants with low birth weight (less than 2,500 g) | Noncore | 8.3 | ||
| Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high | Micropolitan (nonmetro) | 92.5 | ||
| Adult current smokers with a checkup in the last 12 months who received advice to quit smoking | Noncore | 61.3 | ||
| Composite measure: Cancer deaths per 100,000 population per year for all cancers | Noncore | 174.5 | ||
| Infants born in the calendar year who received breastfeeding through 3 months | Nonmetropolitan | 50.3 | ||
| Hospital admissions for immunization-preventable influenza per 100,000 population, adults age 65 and over | Noncore | 77.9 | ||
| Adjuvant chemotherapy was recommended or administered within 4 months of diagnosis for patients under the age of 80 with AJCC Stage III lymph node positive colon cancer | Noncore | 92.1 | ||
| Adults with a dental visit in the calendar year | Noncore | 29.9 | ||
| 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 | 43.8 | ||
| Adults with obesity who ever received advice from a health professional to exercise more | Noncore | 58.2 | ||
| Adults who received a preventive dental service in the calendar year | Noncore | 21.1 | ||
| Deaths per 1,000 adult hospital admissions with acute myocardial infarction (AMI) | Noncore | 51.7 | ||
| Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months | Noncore | 76.1 | ||
| Composite: People unable to get or delayed in getting needed medical care, dental care, or prescription medicines due to financial or insurance reasons | Noncore | 43.4 | ||
| People unable to get or delayed in getting needed medical care due to financial or insurance reasons | Nonmetropolitan | 31.3 | ||
| Patients aged 65 and over with an emergency department (ED) visit and with a dementia diagnosis who were hospitalized following the ED visit | Noncore | 53.1 | ||
| Cesarean delivery of low risk births giving birth for first time | Noncore | 25.6 | ||
| Cesarean delivery of low risk births with prior cesarean births | Noncore | 89.1 | ||
| People unable to get or delayed in getting needed dental care due to financial or insurance reasons | Nonmetropolitan | 69.4 | ||
| People unable to get or delayed in getting needed prescription medicines due to financial or insurance reasons | Nonmetropolitan | 55.7 | ||
| Total cesarean births | Noncore | 32.1 | ||
| Total preterm births | Noncore | 10.4 | ||
| Late preterm or live births at 34 to 36 weeks of gestation | Noncore | 7.6 | ||
| Deaths per 1,000 hospital admissions with coronary artery bypass surgery, adults age 40 and over | Noncore | 24.1 | ||
| Children who had a doctor's office or clinic visit in the last 12 months whose health providers always listened carefully | Noncore | 82.0 | ||
| Children who had a doctor's office or clinic visit in the last 12 months whose health providers always showed respect for what they or their parents had to say | Noncore | 82.4 | ||
| Children who had a doctor's office or clinic visit in the last 12 months whose health providers always spent enough time with them | Noncore | 82.8 | ||
| Composite measure: Emergency department visits with a principal diagnosis related to mental health, alcohol, or substance abuse, per 100,000 population | Noncore | 1724.0 | ||
| Composite measure: Hospitalizations for all conditions per 100,000 population, adults age 18 and over | Noncore | 2164.2 | ||
| Composite measure: Hospital admissions for all conditions per 100,000 population, children age 6-17 | Noncore | 95.7 | ||
| Hospital admissions for acute conditions per 100,000 population, adults age 18 and over | Noncore | 943.1 | ||
| Hospital admissions for acute conditions per 100,000 population, children ages 6-17 | Noncore | 34.2 | ||
| Hospital admissions for chronic conditions per 100,000 population, adults age 18 and over | Noncore | 1221.2 | ||
| Hospital admissions for chronic conditions per 100,000 population, children ages 6-17 | Noncore | 61.4 | ||
| Practices that have computerized system for providing reminders | Non-MSA | 72.2 | ||
| Office-based physicians with a computerized system for clinical decision support | Non-MSA | 68.1 | ||
| Practices that have computerized system for recording patient history and demographic information | Non-MSA | 88.3 | ||
| Office-based physicians with a computerized system for providing clinical notes | Non-MSA | 87.3 | ||
| Practices that have computerized system (not including billing) | Non-MSA | 86.2 | ||
| Practices that have computerized system for discharge summaries | Non-MSA | 78.6 | ||
| 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 | 19.9 | ||
| Adults who received mental health treatment or counseling in the last 12 months | Noncore | 14.0 | ||
| People without a usual source of care who indicated a financial or insurance reason for not having a source of care | Nonmetropolitan | 11.0 | ||
| Practices with E-prescribing system for ordering prescriptions | Non-MSA | 87.6 | ||
| Practices with E-prescribing system for sending prescriptions electronically to pharmacy | Non-MSA | 86.4 | ||
| Practices with E-prescribing system for providing warning of drug interactions or contraindications | Non-MSA | 81.8 | ||
| Adults who received outpatient mental health treatment or counseling in the last 12 months | Noncore | 6.0 | ||
| Adults who received prescription medications for mental health treatment in the last 12 months | Noncore | 12.5 | ||
| Patients aged 65 and over with an emergency department visit and with a dementia diagnosis who were not hospitalized | Noncore | 46.9 | ||
| Children ages 0-17 with wellness checkup in the past 12 months | Micropolitan (nonmetro) | 78.0 | ||
| 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 | Noncore | 52.7 | ||
| 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 | 36.0 | ||
| People who needed to see a doctor but could not because of cost in the past 12 months | Nonmetropolitan | 10.7 | ||
| Hospital admissions for congestive heart failure per 100,000 population | Noncore | 489.9 | ||
| Levels I and II trauma center utilization for all injuries in the U.S. | Noncore | 10.4 | ||
| Level III trauma center utilization for all injuries in the U.S | Noncore | 9.0 | ||
| Non-trauma center utilization for all injuries in the U.S | Noncore | 80.6 | ||
| Children who had a doctor's office or clinic visit in the last 12 months whose health providers always explained things in a way they or their parents could understand | Noncore | 85.7 | ||
| Deaths per 1,000 adult hospital admissions with congestive heart failure | Noncore | 32.7 | ||
| Composite: People age 12 and over who needed treatment for illicit drug use or an alcohol problem and who received such treatment at a specialty facility in the last 12 months | Noncore | 15.8 | ||
| 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 | Nonmetropolitan | 23.9 | ||
| Adults with obesity who ever received advice from a health professional about eating fewer high-fat or high-cholesterol foods | Noncore | 44.2 | ||
| Children ages 2-17 for whom a health provider gave advice within the past 2 years about eating healthy | Noncore | 46.4 | ||
| Composite measure: Children who had a doctor's office or clinic visit in the last 12 months whose health providers always listened carefully, explained things clearly, respected what they or their parents had to say, and spent enough time with them | Noncore | 83.2 | ||
| Deaths per 1,000 adult hospital admissions with abdominal aortic aneurysm (AAA) repair | Noncore | 40.4 |