NationalHigh Income 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 16-17 who received 1 or more doses of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) since the age of ten years-19.2
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-15.7
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined-15.2
Adolescents ages 16-17 who received 1 or more doses of meningococcal conjugate vaccine-13.6
Adults who filled four or more outpatient opioid prescriptions in the calendar year-11.8
Adolescents ages 13-15 who received 1 or more doses of meningococcal conjugate vaccine-11.2
Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis-8.8
Adults who filled an outpatient opioid prescription in the calendar year-8.2
Adolescent males ages 13-15 who received 3 or more doses of human papillomavirus (HPV) vaccine-6.3
Adults who received a blood cholesterol measurement in the last 5 years-6.2
Children ages 19-35 months who received 1 or more doses of varicella vaccine-5.5
Children ages 0-17 with wellness checkup in the past 12 months-5.5
Children who had their height and weight measured by a health provider within the past 2 years-5.4
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)-4.6
Adolescents females ages 16-17 who received 3 or more doses human papillomavirus vaccine-4.6
Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults-4.5
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-4.4
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-4.0
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-3.8
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-3.4
People under age 65 with health insurance-3.1
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-3.0
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-3.0
Children ages 19-35 months who received 3 or more doses of polio vaccine-2.9
Infants born in the calendar year who received breastfeeding exclusively through 3 months-2.9
Children ages 2-17 for whom a health provider gave advice within the past 2 years about eating healthy-2.8
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-2.7
Adults who rated their healthcare received in the last 12 months as poor (0-6) on a scale of 0-10 (where 0 is the worst and 10 is the best)-2.7
Adolescents females ages 13-15 who received 3 or more doses human papillomavirus vaccine-2.7
People under age 65 who were uninsured all year-2.6
Children ages 3-5 who ever had their vision checked by a health provider-2.6
Adults age 65 and over who received an influenza vaccination in the last flu season-2.3
People with a usual source of care who is somewhat to very difficulty to contact during regular business hours over the telephone-2.3
Adults age 65 and over who ever received pneumococcal vaccination-2.1
Adult current smokers who had a doctor's office or clinic visit in the last 12 months who received advice to quit smoking from their providers-2.1
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-2.1
People with a usual source of care who usually asks about prescription medications and treatments from other doctors-2.0
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-1.8
Adults ages 18 and over who received influenza vaccination in the last flu season-1.8
People under age 65 with any period of uninsurance during the year-1.5
Children ages 12-17 with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months-1.4
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-1.3
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-1.1
Measures That Are Unchanged
MeasureAverage Annual Percent Change
Adults with limited English proficiency and usual source of care (USC) and the USC had language assistance-18.3
Adults age 40 and over with diabetes whose condition was diagnosed-4.9
Adolescent males ages 16-17 who received 3 or more doses of human papillomavirus (HPV) vaccine-2.5
Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high-1.9
Children ages 2-19 with obesity-1.3
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-1.2
Adults with obesity age 20 and over who had been told by a doctor or health professional that they were overweight-1.1
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-0.9
Adults with obesity who ever received advice from a health professional to exercise more-0.8
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-0.7
Adults with hypertension with blood pressure less than 140/90 mm/Hg-0.7
Adults ages 18-64 at high risk (e.g., COPD) who ever received pneumococcal vaccination-0.7
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-0.6
Children ages 6 months to 17 years who received influenza vaccination in the last flu season-0.6
Adults ages 18-64 at high risk (e.g., COPD) who received an influenza vaccination in the last flu season-0.6
Adults age 40 and over with diagnosed diabetes with blood pressure less than 130/80 mm Hg-0.6
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-0.6
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-0.6
People who were unable to get or delayed in getting needed medical care in the last 12 months-0.5
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-0.4
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year-0.3
Adults age 40 and over with diagnosed diabetes who received a flu vaccination in the calendar year-0.3
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-0.2
People who were unable to get or delayed in getting needed dental care in the last 12 months-0.1
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c measurements in the calendar year-0.1
People unable to get or delayed in getting needed prescription medicines due to financial or insurance reasons-0.1
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms-0.1
Adults with obesity who ever received advice from a health professional about eating fewer high-fat or high-cholesterol foods-0.1
People without a usual source of care who indicated a financial or insurance reason for not having a source of care0.0
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 months0.1
People age 12 and over who needed treatment for alcohol problem who received such treatment at a specialty facility in the last 12 months0.1
People under age 65 with any private health insurance0.2
Adults who received a preventive dental service in the calendar year0.2
Children ages 19-35 months who received 4 or more doses of diphtheria-tetanus-pertussis vaccine0.2
Children ages 5-17 with untreated dental caries0.2
People with a specific source of ongoing care0.2
Children ages 2-17 who received a preventive dental service in the calendar year0.2
People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends0.3
People unable to get or delayed in getting needed medical care due to financial or insurance reasons0.4
Adults with a dental visit in the calendar year0.5
Children ages 2-17 who had a dental visit in the calendar year0.5
People with a usual primary care provider0.6
Children ages 19-35 months who received 1 or more doses of measles-mumps-rubella vaccine0.7
Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months0.7
People in fair or poor health with a specific source of ongoing care0.8
Children ages 19-35 months who received 3 or more doses of hepatitis B vaccine0.9
Adults with limited English proficiency who had a usual source of care1.7
Children who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist2.5
Children 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 treatment4.4
Measures That Are Worsening
MeasureAverage Annual Percent Change
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year1.3
People unable to get or delayed in getting needed dental care due to financial or insurance reasons1.4
People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler)1.7
People who were unable to get or delayed in getting needed prescription medicines in the last 12 months1.7
Women ages 50-74 who received a mammogram in the last 2 years1.8
Adults age 65 and over with any private health insurance2.9
Women ages 21-65 who received a Pap smear in the last 3 years3.9
People under age 65 whose family's health insurance premium and out-of-pocket medical expenditures were more than 10% of total family income4.0
Hospital inpatient stays involving opioid-related diagnoses per 100,000 population5.7
Emergency department visits involving opioid-related diagnoses per 100,000 population10.3
Measures With No Available Trend Information or Supplemental Measures
MeasureAverage Annual Percent Change
Adults who tried to make an appointment for seeing a specialist in the last 12 months who sometimes or never found it easy to get the appointment
Sepsis diagnoses per 1,000 elective-surgery admissions of length 4 or more days, adults
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
Postoperative acute kidney injury requiring dialysis per 1,000 elective surgical hospital discharges, adults
Postoperative pulmonary embolism (PE) or deep vein thrombosis (DVT) per 1,000 surgical hospital discharges, adults
Postoperative respiratory failure per 1,000 elective surgical hospital discharges, adults
Postoperative physiologic and metabolic derangements per 1,000 elective surgical hospital discharges, adults
Postoperative hip fracture per 1,000 surgical admissions who were not susceptible to falling, adults
Reclosure of postoperative abdominal wound dehiscence per 1,000 abdominopelvic-surgery admissions of length 2 or more days, adults
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, adults
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, children
Hospital admissions with iatrogenic pneumothorax per 1,000 medical and surgical admissions, adults
Deaths per 1,000 elective-surgery admissions having developed specified complications of care during hospitalization, adults ages 18-89 or obstetric admissions
Deaths per 1,000 hospital admissions with expected low-mortality
Birth trauma - injury to neonate per 1,000 selected live births
Obstetric trauma per 1,000 vaginal deliveries without instrument assistance
Obstetric trauma per 1,000 instrument-assisted deliveries
Emergency department visits with a principal diagnosis related to mental health only per 100,000 population
Emergency department visits with a principal diagnosis related to substance abuse only, per 100,000 population
Emergency department encounters for asthma, adults
Emergency department encounters for asthma, children ages 2-17
Hospital admissions for uncontrolled diabetes without complications per 100,000 population, adults
Hospital admissions for short-term complications of diabetes per 100,000 population, adults
Hospital admissions for short-term complications of diabetes per 100,000 population, children ages 6-17
Hospital admissions for long-term complications of diabetes per 100,000 population, adults
Hospital admissions for lower extremity amputations per 1,000 population, adults age 18 and over with diabetes
Hospital admissions for asthma per 100,000 population, adults ages 18-39
Hospital admissions for asthma per 100,000 population, children ages 2-17
Hospitalizations and emergency department encounters for heart failure
Hospital admissions for perforated appendix per 1,000 admissions with appendicitis, children
Hospital admissions for hypertension per 100,000 population, adults age 18 and over
Hospital admissions for chronic obstructive pulmonary disease or asthma per 100,000 population, adults age 40 and over
Hospital admissions for community-acquired pneumonia per 100,000 population, adults age 18 and over
Hospital admissions for urinary tract infection (UTI) per 100,000 population, adults age 18 and over
Hospital admissions for urinary tract infection (UTI) per 100,000 population, children ages 3 months to 17 years
Hospital admissions for pediatric gastroenteritis per 100,000 population, children ages 3 months to 17 years
Deaths per 1,000 adult hospital admissions with acute myocardial infarction (AMI)
Hospital admissions for heart failure per 100,000 population
Deaths per 1,000 adult hospital admissions with heart failure
Deaths per 1,000 adult hospital admissions with abdominal aortic aneurysm (AAA) repair
Deaths per 1,000 hospital admissions with coronary artery bypass surgery, adults age 40 and over
Deaths per 1,000 hospital admissions with percutaneous transluminal coronary angioplasty (PTCA), adults age 40 and over
People age 12 and over with opioid (either prescription opioid or heroin) use disorder in the past year
Deaths per 1,000 adult hospital admissions with pneumonia
Persons with current asthma who received written asthma management plans from their healthcare provider
Hospital admissions for immunization-preventable influenza per 100,000 population, adults age 65 and over