NationalAmerican Indian/Alaska Native (AI/AN) Quality Measures Trend Over Time

Trending information is available for NHQDR quality measures with at least four years of data. The time span can vary across measures. Trends are only reported as improving or worsening if the average annual percent change is at least one percent and statistically significant.

Measures That Are Improving
MeasureAverage Annual Percent Change
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-24.3
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-22.1
Adolescents ages 13-15 who received 1 or more doses of meningococcal conjugate vaccine-20.9
Long-stay nursing home residents with physical restraints-19.8
Long-stay nursing home residents with a urinary tract infection-14.7
Adolescents ages 16-17 who received 1 or more doses of meningococcal conjugate vaccine-14.5
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined-13.3
Short-stay home health patients who had diabetic foot care and patient education-13.1
Long-stay nursing home residents have depressive symptoms-10.3
Home health care patients whose shortness of breath decreased-8.8
Home health care patients whose ability to get in and out of bed improved-8.5
Home health care patients whose ability to walk or move around improved-8.4
Home health care patients whose management of oral medications improved-7.9
Home health care patients whose bathing improved-7.8
Home health patients who had improvement in upper body dressing-6.8
Short-stay nursing home residents with moderate to severe pain-6.5
Adults ages 18-64 at high risk (e.g., COPD) who received an influenza vaccination in the last flu season-6.3
Children ages 19-35 months who received 1 or more doses of varicella vaccine-6.2
HIV infection deaths per 100,000 population-5.9
Adult hospital patients who did not receive good communication about discharge information-5.8
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms-5.8
People with a specific source of ongoing care-5.7
Children ages 0-17 with wellness checkup in the past 12 months-5.2
Persons age 13 and over living with HIV who know their serostatus-4.8
Adults who received a blood cholesterol measurement in the last 5 years-4.7
Children ages 2-17 for whom a health provider gave advice within the past 2 years about eating healthy-4.6
Children ages 19-35 months who received 3 or more doses of hepatitis B vaccine-4.5
Adults ages 18 and over who received influenza vaccination in the last flu season-4.5
Adjusted incident rates of end stage renal disease (ESRD) due to diabetes per million population-4.2
Adult hospital patients who sometimes or never had good communication about medications they received in the hospital-4.0
Adult hemodialysis patients who use arteriovenous fistulas as the primary mode of vascular access-3.7
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-3.3
Adults who reported that home health providers talk about pain in the last 2 months of care-2.7
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-2.4
Adults who reported being told what care and services they would get when they first started getting home health care-2.4
People under age 65 with health insurance-2.3
Colorectal cancer diagnosed at advanced stage (tumors diagnosed at regional or distant stage) per 100,000 population age 50 and over-2.2
Lung cancer deaths per 100,000 population per year-1.7
Home health care patients who stayed at home after an episode of home health care-1.6
Breast cancer deaths per 100,000 female population per year-1.5
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-1.2
Colorectal cancer deaths per 100,000 population per year-1.2
Adult end stage renal disease (ESRD) patients who saw a nephrologist at least 12 months prior to initiation of renal replacement therapy-1.1
Cervical cancer diagnosed at advanced stage (all invasive tumors) per 100,000 women age 20 and over-1.1
Measures That Are Unchanged
MeasureAverage Annual Percent Change
Adults age 65 and over who received an influenza vaccination in the last flu season-44.3
Acute stroke patients for whom IV thrombolytic therapy was initiated at hospital within 3 hours of time last known well-15.6
Short-stay nursing home patients with pressure ulcers that are new or worsened-15.4
Home health patients who had timely initiation of care-8.2
Hospital patients who received influenza vaccination-7.0
Home health care patients whose pain when moving around decreased-6.8
Children who had their height and weight measured by a health provider within the past 2 years-6.6
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)-6.4
Long-stay nursing home residents with moderate to severe pain-4.4
People in fair or poor health with a specific source of ongoing care-4.3
Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis-4.1
Children ages 19-35 months who received 3 or more doses of polio vaccine-3.7
Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment-2.7
Low-risk, long-stay nursing home residents with a catheter inserted and left in the bladder-2.5
Infants born in the calendar year who received breastfeeding through 3 months-2.5
Adults age 65 and over who ever received pneumococcal vaccination-2.2
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-2.0
People who were unable to get or delayed in getting needed prescription medicines in the last 12 months-1.8
Short-stay nursing home patients who had flu vaccination appropriately given-1.8
Children ages 2-17 who had a dental visit in the calendar year-1.8
People with a usual source of care who is somewhat to very difficulty to contact during regular business hours over the telephone-1.7
Adult hospital patients who strongly disagree or disagree that staff took their preferences and those of their family and caregiver into account when deciding what the patients discharge health care would be-1.6
Long-stay nursing home patients who were assessed and appropriately given the seasonal influenza vaccine-1.5
Short-stay nursing home residents who were assessed for pneumococcal vaccination-1.5
People who were unable to get or delayed in getting needed dental care in the last 12 months-1.4
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-1.3
Home health care patients who had to be admitted to the hospital-1.1
Children ages 2-17 who received a preventive dental service in the calendar year-1.0
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-1.0
People under age 65 whose family's health insurance premium and out-of-pocket medical expenditures were more than 10% of total family income-1.0
Long-stay nursing home residents whose need for help with daily activities increased-0.9
Infant mortality per 1,000 live births, birth weight 2,500 grams or more-0.9
People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends-0.9
Adults who reported that home health providers always treated them with courtesy and respect in the last 2 months of care-0.9
Long-stay nursing home residents with too much weight loss-0.8
Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high-0.8
Children ages 19-35 months who received 4 or more doses of diphtheria-tetanus-pertussis vaccine-0.7
Children ages 19-35 months who received 1 or more doses of measles-mumps-rubella vaccine-0.7
Adults who filled an outpatient opioid prescription in the calendar year-0.6
Adults ages 18-64 at high risk (e.g., COPD) who ever received pneumococcal vaccination-0.6
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-0.6
Adults who reported that home health providers always listen carefully to them in the last 2 months of care-0.6
Long-stay nursing home residents whose ability to move independently worsened-0.5
People under age 65 who were uninsured all year-0.5
Low-risk, long-stay nursing home residents with loss of control of bowels or bladder-0.4
Children ages 6 months to 17 years who received influenza vaccination in the last flu season-0.4
Adults who received a preventive dental service in the calendar year-0.3
Breast cancer diagnosed at advanced stage (regional, distant stage, or local stage with tumor greater than 2 cm) per 100,000 women age 40 and over-0.3
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-0.2
Adults who did not have any problem with the care they received from their home health providers in the last 2 months of care-0.2
High-risk, long-stay nursing home patients with pressure ulcer-0.2
People under age 65 with any period of uninsurance during the year-0.1
Adults with a dental visit in the calendar year-0.1
Adults who reported that home health providers always treated them as gently as possible in the last 2 months of care-0.1
People who were unable to get or delayed in getting needed medical care in the last 12 months-0.1
Dialysis patients who were registered on a waiting list for transplantation-0.0
People with a usual primary care provider0.3
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 care0.3
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 understand0.3
People with a usual source of care who usually asks about prescription medications and treatments from other doctors0.3
Women ages 21-65 who received a Pap smear in the last 3 years0.4
Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure0.5
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never listened carefully to them0.5
Long-stay nursing home residents who were assessed for pneumococcal vaccination0.5
Home health care patients whose surgical wound was improved0.7
Live-born infants with low birth weight (less than 2,500 g)0.7
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 care0.8
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 care0.8
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 months0.8
People under age 65 with any private health insurance0.9
Adults who reported that home health providers talked with them about when to take medicines in the last 2 months of care0.9
Adults age 65 and over with any private health insurance0.9
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 them1.4
Hospital patients who received pneumococcal immunization1.4
New HIV cases per 100,000 population age 13 and over2.3
Long-stay nursing home patients experiencing one or more falls with major injury2.6
Home health care patients who had an emergency department visit and then hospitalized3.4
Measures That Are Worsening
MeasureAverage Annual Percent Change
Adults who reported getting the help or advice they needed the same day they contacted their home health providers1.0
Adults who reported getting the help or advice they needed when they contacted their home health providers in the last 2 months of care1.7
Home health care patients who had an emergency department visit without a hospitalization2.8
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 care3.0
Suicide deaths among persons age 12 and over per 100,000 population3.4
Drug overdose deaths involving any opioid per 100,000 resident population7.3
Drug overdose deaths involving natural and semisynthetic opioids per 100,000 resident population8.7
Drug overdose deaths involving other synthetic opioids (other than methadone) per 100,000 resident population9.5