NationalOlder Adults 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
Home health patients who had influenza vaccination during flu season-38.3
Long-stay nursing home residents with physical restraints-30.2
Adverse drug event with IV heparin in adult hospital patients who received an anticoagulant-22.6
Adult hemodialysis patients with adequate dialysis - (Kt/V) 1.2 or higher-20.1
Long-stay nursing home residents with a urinary tract infection-17.8
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined-13.6
Short-stay nursing home residents with moderate to severe pain-12.3
Home health care patients whose ability to get in and out of bed improved-12.2
Long-stay nursing home residents with moderate to severe pain-11.5
Home health care patients whose ability to walk or move around improved-10.4
Short-stay nursing home patients with pressure ulcers that are new or worsened-10.2
Long-stay nursing home residents have depressive symptoms-10.0
Home health care patients whose pain when moving around decreased-9.8
Home health care patients whose shortness of breath decreased-9.8
Home health care patients whose bathing improved-8.7
Adults who received a blood cholesterol measurement in the last 5 years-6.7
Home health care patients whose management of oral medications improved-6.6
Home health patients who had improvement in upper body dressing-6.5
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-6.4
Home health care patients whose surgical wound was improved-5.1
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-4.9
Home health patients who had improvement in toileting-4.6
Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment-4.6
Adults age 40 and over with diabetes whose condition was diagnosed-4.4
Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults-4.3
Adult hospital patients who did not receive good communication about discharge information-4.2
Low-risk, long-stay nursing home residents with a catheter inserted and left in the bladder-4.1
Long-stay nursing home patients who were assessed and appropriately given the seasonal influenza vaccine-4.1
Colorectal cancer diagnosed at advanced stage (tumors diagnosed at regional or distant stage) per 100,000 population age 50 and over-3.7
Adults who reported that home health providers talk about pain in the last 2 months of care-3.7
High-risk, long-stay nursing home patients with pressure ulcer-3.5
Colorectal cancer deaths per 100,000 population per year-3.3
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-3.2
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-3.2
Long-stay nursing home residents whose need for help with daily activities increased-3.1
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-2.8
Cervical cancer diagnosed at advanced stage (all invasive tumors) per 100,000 women age 20 and over-2.7
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-2.5
Adults age 65 and over who received an influenza vaccination in the last flu season-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-2.4
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)-2.4
Lung cancer deaths per 100,000 population per year-2.2
Adult end stage renal disease (ESRD) patients who saw a nephrologist at least 12 months prior to initiation of renal replacement therapy-2.1
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-2.0
Family caregivers who received right amount of emotional and spiritual supports from hospice care team-2.0
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)-2.0
Adults age 65 and over who ever received pneumococcal vaccination-2.0
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-1.8
Adult hospital patients who sometimes or never had good communication about medications they received in the hospital-1.7
Adults who reported being told what care and services they would get when they first started getting home health care-1.6
Breast cancer deaths per 100,000 female population per year-1.6
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-1.5
Adults ages 18 and over who received influenza vaccination in the last flu season-1.5
Adults age 40 and over with diagnosed diabetes with blood pressure less than 130/80 mm Hg-1.5
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-1.4
People with a usual source of care who is somewhat to very difficulty to contact during regular business hours over the telephone-1.2
Home health care patients who had to be admitted to the hospital-1.2
Adult hemodialysis patients who use arteriovenous fistulas as the primary mode of vascular access-1.1
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)-1.1
Adults who reported that home health providers always treated them with courtesy and respect in the last 2 months of care-1.1
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-1.1
Measures That Are Unchanged
MeasureAverage Annual Percent Change
Hospital patients with an anticoagulant-related adverse drug event to low-molecular-weight heparin (LMWH) and factor Xa-11.1
Hospital patients who received a hypoglycemic agent who had an adverse drug events with hypoglycemic agents-6.8
Adults who filled four or more outpatient opioid prescriptions in the calendar year-5.6
Adult surgery patients with catheter-associated urinary tract infection-5.2
Adults who filled an outpatient opioid prescription in the calendar year-5.1
Adults with limited English proficiency who had a usual source of care-2.7
Long-stay nursing home residents whose ability to move independently worsened-1.4
People without a usual source of care who indicated a financial or insurance reason for not having a source of care-1.3
Adults with hypertension with blood pressure less than 140/90 mm/Hg-1.2
Short-stay nursing home patients who had flu vaccination appropriately given-1.1
Long-stay nursing home residents with too much weight loss-0.9
Hospice patients whose hospice care team always communicated well with their family caregivers about taking care them-0.9
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-0.9
People with a usual source of care who usually asks about prescription medications and treatments from other doctors-0.8
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year-0.8
Adults with obesity who ever received advice from a health professional to exercise more-0.8
Hospice patients whose hospice care team always treated them with dignity and respect, and really cared about them-0.8
Adults who received a preventive dental service in the calendar year-0.8
Family members who definitely received trainings about taking care their family member from hospice care team-0.7
People unable to get or delayed in getting needed prescription medicines due to financial or insurance reasons-0.7
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-0.6
Adults with a dental visit in the calendar year-0.6
Family caregivers who would definitely recommend this hospice to their friends and family-0.6
Adults who reported that home health providers always listen carefully to them in the last 2 months of care-0.6
Home health care patients who stayed at home after an episode of home health care-0.5
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year-0.5
People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends-0.3
Adults who reported that home health providers always treated them as gently as possible in the last 2 months of care-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
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
Adjusted incident rates of end stage renal disease (ESRD) due to diabetes per million population-0.2
Hospice patients who always received enough helps for pain, sadness, breathing, or constipations from hospice care team-0.2
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-0.1
Adults with obesity age 20 and over who had been told by a doctor or health professional that they were overweight-0.1
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c measurements in the calendar year-0.0
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-0.0
Short-stay nursing home residents who were assessed for pneumococcal vaccination-0.0
People unable to get or delayed in getting needed medical care due to financial or insurance reasons0.1
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms0.1
Adults age 40 and over with diagnosed diabetes who received a flu vaccination in the calendar year0.2
Hospice patients and family caregivers who always got help as soon as they need from hospice care team0.2
People with a usual primary care provider0.3
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 care0.4
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 care0.5
Adults who reported that home health providers talked with them about when to take medicines in the last 2 months of care0.5
Adults who reported getting the help or advice they needed the same day they contacted their home health providers0.6
People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler)0.6
Adults with obesity who ever received advice from a health professional about eating fewer high-fat or high-cholesterol foods0.6
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers always offered help in filling out forms0.6
Adults who reported getting the help or advice they needed when they contacted their home health providers in the last 2 months of care0.7
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 needed0.8
Hemodialysis patients whose hemoglobin level is less than 10 g/dL0.8
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 treatment1.3
Long-stay nursing home patients experiencing one or more falls with major injury1.9
Adults with limited English proficiency and usual source of care (USC) and the USC had language assistance2.5
Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months4.3
Composite: Inpatient adverse events in adults receiving hip joint replacement due to fracture or degenerative conditions4.5
Measures That Are Worsening
MeasureAverage Annual Percent Change
People unable to get or delayed in getting needed dental care due to financial or insurance reasons1.2
People with a specific source of ongoing care1.4
HIV infection deaths per 100,000 population1.7
Suicide deaths among persons age 12 and over per 100,000 population1.7
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 care1.8
People who were unable to get or delayed in getting needed medical care in the last 12 months2.2
Adults age 65 and over with any private health insurance2.2
Drug overdose deaths involving natural and semisynthetic opioids per 100,000 resident population2.5
Home health care patients who had an emergency department visit and then hospitalized2.5
People who were unable to get or delayed in getting needed prescription medicines in the last 12 months2.5
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 be2.7
Drug overdose deaths involving any opioid per 100,000 resident population2.7
Home health care patients who had an emergency department visit without a hospitalization3.1
Low-risk, long-stay nursing home residents with loss of control of bowels or bladder3.3
People who were unable to get or delayed in getting needed dental care in the last 12 months3.3
People in fair or poor health with a specific source of ongoing care4.5
Long-stay nursing home residents who were assessed for pneumococcal vaccination4.8
Hospital inpatient stays involving opioid-related diagnoses per 100,000 population9.2
Emergency department visits involving opioid-related diagnoses per 100,000 population12.1
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
Adult surgery patients with postoperative pneumonia events
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
Inpatient adverse events in adults receiving hip joint replacement due to fracture
Accidental puncture or laceration during procedure per 1,000 medical and surgical admissions, adults
Hospital admissions with iatrogenic pneumothorax per 1,000 medical and surgical admissions, adults
Deaths per 1,000 hospital admissions with expected low-mortality
Hospital patients with an anticoagulant-related adverse drug event to warfarin
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 visits with a principal diagnosis related to dental conditions
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 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
Hospitalizations and emergency department encounters for heart failure
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
Deaths per 1,000 adult hospital admissions with acute myocardial infarction (AMI)
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
Hospital admissions for heart failure per 100,000 population
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
Hospital patients who received influenza vaccination
Home health patients who had pneumococcal polysaccharide vaccination