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:

 
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
Adults who received a blood cholesterol measurement in the last 5 years Micropolitan (nonmetro) 81.3 82.3 1.2%
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) Noncore 94.0 96.8 2.9%
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined Noncore 91.5 95.3 3.9%
Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis Noncore 92.9 97.0 4.2%
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c measurements in the calendar year Nonmetropolitan 76.1 79.5 4.3%
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 88.2 95.9 8.0%
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 87.4 95.2 8.2%
Women ages 21-65 who received a Pap smear in the last 3 years Micropolitan (nonmetro) 79.1 86.9 9.0%
Measures That Are Close to Benchmark
Measure Population Estimate Benchmark Distance to Benchmark
Breast cancer deaths per 100,000 female population per year Noncore 20.5 17.8 15.3%
Adults age 40 and over with diagnosed diabetes who received a flu vaccination in the calendar year Noncore 55.1 65.8 16.3%
Adolescents ages 13-15 who received 1 or more doses of meningococcal conjugate vaccine Nonmetropolitan 73.9 95.4 22.6%
Adolescents ages 16-17 who received 1 or more doses of meningococcal conjugate vaccine Nonmetropolitan 74.3 96.2 22.7%
Women ages 50-74 who received a mammogram in the last 2 years Micropolitan (nonmetro) 64.2 85.2 24.6%
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year Noncore 56.4 75.2 25.0%
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year Noncore 57.3 84.0 31.8%
Colorectal cancer deaths per 100,000 population per year Noncore 16.6 11.5 43.8%
HIV infection deaths per 100,000 population Noncore 1.1 0.8 46.7%
Measures That Are Far From Benchmark
Measure Population Estimate Benchmark Distance to Benchmark
Adolescent males ages 13-15 who received 3 or more doses of human papillomavirus (HPV) vaccine Nonmetropolitan 21.1 43.2 51.2%
Lung cancer deaths per 100,000 population per year Noncore 48.2 27.5 75.5%
Suicide deaths among persons age 12 and over per 100,000 population Noncore 22.9 9.4 144.1%
Drug overdose deaths involving natural and semisynthetic opioids per 100,000 resident population Micropolitan (nonmetro) 5.0 1.9 166.0%
Hospital inpatient stays involving opioid-related diagnoses per 100,000 population Noncore 280.8 102.9 173.0%
Drug overdose deaths involving any opioid per 100,000 resident population Micropolitan (nonmetro) 13.9 4.0 244.1%
Emergency department visits involving opioid-related diagnoses per 100,000 population Noncore 231.6 65.2 254.9%
Drug overdose deaths involving other synthetic opioids (other than methadone) per 100,000 resident population Micropolitan (nonmetro) 7.7 0.7 954.8%
Measures With No Available Benchmark Information or Supplemental Measures
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