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NationalChronic Care Quality Measures Compared to Achievable Benchmarks

The NHQDR quality measures specific to Chronic Care 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 Estimate Benchmark Distance to Benchmark
Long-stay nursing home residents with a urinary tract infection 2.2 2.8 Achieved: 23% better
Home health care patients whose pain when moving around decreased 78.7 75.1 Achieved: 5% better
Home health care patients whose ability to get in and out of bed improved 75.6 72.6 Achieved: 4% better
Home health care patients whose ability to walk or move around improved 76.4 74.2 Achieved: 3% better
Home health care patients whose management of oral medications improved 67.7 66.2 Achieved: 2% better
Home health care patients whose bathing improved 78.7 78.2 Achieved: 1% better
Adult hemodialysis patients with adequate dialysis - (Kt/V) 1.2 or higher 96.4 96.5 0.1%
Home health care patients whose shortness of breath decreased 78.0 78.4 0.5%
Home health patients who had improvement in upper body dressing 78.2 79.3 1.3%
Adults who did not have any problem with the care they received from their home health providers in the last 2 months of care 92.7 94.0 1.4%
Family caregivers who received right amount of emotional and spiritual supports from hospice care team 89.6 90.9 1.5%
Adults who reported that home health providers always treated them with courtesy and respect in the last 2 months of care 93.6 95.0 1.5%
Adults who reported that home health providers talk about pain in the last 2 months of care 89.8 91.2 1.6%
Home health care patients whose surgical wound was improved 91.5 93.1 1.7%
Adults who reported being told what care and services they would get when they first started getting home health care 89.4 91.3 2.1%
Adults who reported that home health providers always treated them as gently as possible in the last 2 months of care 90.2 92.5 2.5%
Hospice patients whose hospice care team always treated them with dignity and respect, and really cared about them 89.8 92.1 2.5%
Adults who reported that home health providers always explained things in a way that was easy to understand in the last 2 months of care 83.6 86.8 3.7%
Hospice patients whose hospice care team always communicated well with their family caregivers about taking care them 80.1 83.3 3.8%
Adults who reported that home health providers always listen carefully to them in the last 2 months of care 84.5 87.9 3.9%
Family caregivers who rated the hospice care for their family member best (9-10) on a scale of 0-10 (where 0 is the worst and 10 is the best) 80.5 83.9 4.1%
Family caregivers who would definitely recommend this hospice to their friends and family 84.7 88.4 4.2%
Home health care patients who stayed at home after an episode of home health care 81.9 85.5 4.3%
Adults who reported that home health providers always seem informed and up-to-date about all the cares or treatments they got at home in the last 2 months of care 64.7 67.6 4.3%
Adults who reported a home health provider talking with them about how to set up their home so they can move around safely when they first started getting home health care 76.6 80.1 4.4%
Adults who reported that home health providers always kept them informed about when they would arrive at their home in the last 2 months of care 79.6 83.3 4.4%
Adults who reported a home health provider talking with them about all the prescription and over-the-counter medicines they were taking when they first started getting home health care 84.1 88.2 4.7%
Home health patients who had improvement in toileting 75.2 78.9 4.7%
Hospice patients who always received enough helps for pain, sadness, breathing, or constipations from hospice care team 75.0 79.0 5.1%
Hospice patients and family caregivers who always got help as soon as they need from hospice care team 77.5 82.3 5.9%
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c measurements in the calendar year 74.6 79.5 6.1%
Family members who definitely received trainings about taking care their family member from hospice care team 73.1 78.4 6.7%
Short-stay nursing home residents with moderate to severe pain 11.3 10.5 7.6%
Adults age 40 and over with diagnosed diabetes who received a flu vaccination in the calendar year 60.4 65.8 8.3%
Measures That Are Close to Benchmark
Measure Estimate Benchmark Distance to Benchmark
Adult hemodialysis patients who use arteriovenous fistulas as the primary mode of vascular access 65.1 72.8 10.5%
Adults who reported a home health provider asking to see all the prescription and over-the-counter medicines they were taking, when they first started getting home health care 76.5 85.5 10.5%
Persons age 13 and over living with diagnosed HIV who had at least two CD4 or viral load tests performed at least 3 months apart during the last year, among reporting jurisdictions 57.6 66.2 13.0%
Long-stay nursing home residents with too much weight loss 5.3 4.7 13.4%
Adults who reported that home health providers talked with them about the purpose for taking their new or changed prescription medicines in the last 2 months of care 31.0 35.9 13.7%
Long-stay nursing home residents whose ability to move independently worsened 23.9 20.7 15.5%
Adults who reported that home health providers talked with them about when to take medicines in the last 2 months of care 28.3 33.9 16.5%
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year 61.7 75.2 17.9%
Low-risk, long-stay nursing home residents with loss of control of bowels or bladder 74.3 63.0 18.0%
Adults home health patients age 18 and over who reported that home health providers talked with them about the side effects of medicines in the last 2 months of care 24.2 29.5 18.1%
Persons age 13 and over living with diagnosed HIV whose most recent viral load in the last 12 months was under 200 copies/mL 61.5 76.1 19.2%
Adults who reported getting the help or advice they needed when they contacted their home health providers in the last 2 months of care 24.3 30.4 20.1%
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year 66.8 84.0 20.5%
Long-stay nursing home residents whose need for help with daily activities increased 20.7 17.1 21.2%
Adult end stage renal disease (ESRD) patients who saw a nephrologist at least 12 months prior to initiation of renal replacement therapy 37.6 54.1 30.4%
Low-risk, long-stay nursing home residents with a catheter inserted and left in the bladder 2.8 2.1 32.1%
Hemodialysis patients whose hemoglobin level is less than 10 g/dL 21.6 16.1 33.8%
Short-stay nursing home patients with pressure ulcers that are new or worsened 0.4 0.3 35.5%
Long-stay nursing home patients experiencing one or more falls with major injury 0.6 0.4 39.5%
Long-stay nursing home residents with physical restraints 0.4 0.3 40.7%
Long-stay nursing home residents with moderate to severe pain 6.2 4.3 42.7%
Dialysis patients who were registered on a waiting list for transplantation 15.8 28.2 43.9%
Measures That Are Far From Benchmark
Measure Estimate Benchmark Distance to Benchmark
Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure 12.5 28.8 56.6%
High-risk, long-stay nursing home patients with pressure ulcer 4.8 3.0 59.1%
Long-stay nursing home residents have depressive symptoms 4.5 1.1 295.6%
Measures With No Available Benchmark Information
Measure Estimate Benchmark Distance to Benchmark
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 1.3
Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults 9.6
People with a usual source of care who usually asks about prescription medications and treatments from other doctors 81.5
Adults with hypertension with blood pressure less than 140/90 mm/Hg 18.2
Adults age 40 and over with diabetes whose condition was diagnosed 79.3
Adults age 40 and over with diagnosed diabetes with blood pressure less than 130/80 mm Hg 52.1
Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months 64.8
Children ages 12-17 with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months 41.4
Adults who filled four or more outpatient opioid prescriptions in the calendar year 3.6
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms 74.0
People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler) 22.3
Persons with current asthma who received written asthma management plans from their healthcare provider 35.5