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
Long-stay nursing home residents with physical restraints-29.2
Acute stroke patients for whom IV thrombolytic therapy was initiated at hospital within 3 hours of time last known well-28.3
Long-stay nursing home residents with a urinary tract infection-14.4
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined-13.7
Hospital patients with an anticoagulant-related adverse drug event to low-molecular-weight heparin (LMWH) and factor Xa-12.2
Short-stay home health patients who had diabetic foot care and patient education-11.6
Long-stay nursing home residents with moderate to severe pain-11.2
Short-stay nursing home residents with moderate to severe pain-11.2
Short-stay nursing home patients with pressure ulcers that are new or worsened-10.5
Home health patients who had timely initiation of care-9.5
Long-stay nursing home residents have depressive symptoms-9.4
Home health care patients whose ability to get in and out of bed improved-8.9
Home health care patients whose ability to walk or move around improved-8.3
Inpatient adverse events in adults receiving hip joint replacement due to fracture-8.1
Adult surgery patients with catheter-associated urinary tract infection-7.7
Home health care patients whose shortness of breath decreased-7.5
Home health care patients whose pain when moving around decreased-7.5
Home health care patients whose bathing improved-6.7
Adults who received a blood cholesterol measurement in the last 5 years-6.7
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-6.3
Hospital patients who received a hypoglycemic agent who had an adverse drug events with hypoglycemic agents-6.3
Home health patients who had improvement in upper body dressing-5.1
Home health care patients whose management of oral medications improved-5.1
Adult hospital patients who did not receive good communication about discharge information-4.7
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-4.4
Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment-4.4
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-4.2
Colorectal cancer diagnosed at advanced stage (tumors diagnosed at regional or distant stage) per 100,000 population age 50 and over-3.9
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 them-3.9
High-risk, long-stay nursing home patients with pressure ulcer-3.8
Long-stay nursing home patients who were assessed and appropriately given the seasonal influenza vaccine-3.8
Adults who reported that home health providers talk about pain in the last 2 months of care-3.5
Colorectal cancer deaths per 100,000 population per year-3.4
Adult current smokers with a checkup in the last 12 months who received advice to quit smoking-3.3
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-3.1
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 listened carefully to them-2.7
Adults age 65 and over who received an influenza vaccination in the last flu season-2.6
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-2.5
Adult hospital patients who sometimes or never had good communication about medications they received in the hospital-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
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-2.3
Long-stay nursing home residents whose need for help with daily activities increased-2.3
Adult end stage renal disease (ESRD) patients who saw a nephrologist at least 12 months prior to initiation of renal replacement therapy-2.1
Lung cancer deaths per 100,000 population per year-2.1
Adults age 65 and over who ever received pneumococcal vaccination-1.8
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-1.7
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-1.7
Adults ages 18 and over who received influenza vaccination in the last flu season-1.7
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 age 40 and over with diagnosed diabetes with blood pressure less than 130/80 mm Hg-1.5
Adults who reported being told what care and services they would get when they first started getting home health care-1.4
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-1.4
Home health care patients who had to be admitted to the hospital-1.3
Adults who reported that home health providers always treated them with courtesy and respect in the last 2 months of care-1.1
Measures That Are Unchanged
MeasureAverage Annual Percent Change
Hospital patients who received influenza vaccination-5.9
Adult surgery patients with postoperative pneumonia events-5.7
Adults who filled four or more outpatient opioid prescriptions in the calendar year-5.4
Adverse drug event with IV heparin in adult hospital patients who received an anticoagulant-4.8
Adults who filled an outpatient opioid prescription in the calendar year-3.5
Hospital patients with an anticoagulant-related adverse drug event to warfarin-3.0
Low-risk, long-stay nursing home residents with a catheter inserted and left in the bladder-2.9
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)-2.7
Hospital patients with heart attack given fibrinolytic medication within 30 minutes of arrival-2.3
Adults with hypertension with blood pressure less than 140/90 mm/Hg-1.2
People unable to get or delayed in getting needed prescription medicines due to financial or insurance reasons-1.1
Adult hemodialysis patients who use arteriovenous fistulas as the primary mode of vascular access-1.1
People with a usual source of care who usually asks about prescription medications and treatments from other doctors-1.1
People without a usual source of care who indicated a financial or insurance reason for not having a source of care-1.0
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-1.0
Short-stay nursing home patients who had flu vaccination appropriately given-1.0
Long-stay nursing home residents with too much weight loss-0.9
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year-0.9
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-0.8
Home health care patients who stayed at home after an episode of home health care-0.8
Adults with obesity who ever received advice from a health professional to exercise more-0.8
Adults who received a preventive dental service in the calendar year-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 age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year-0.6
Adults with a dental visit in the calendar year-0.5
Adults who reported that home health providers always listen carefully to them in the last 2 months of care-0.5
Adults who reported that home health providers always treated them as gently as possible in the last 2 months of care-0.3
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c measurements 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
People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends-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-0.2
Adults who did not have any problem with the care they received from their home health providers in the last 2 months of care-0.1
Adults with obesity age 20 and over who had been told by a doctor or health professional that they were overweight-0.1
Adjusted incident rates of end stage renal disease (ESRD) due to diabetes per million population0.0
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers always offered help in filling out forms0.1
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 care0.1
Long-stay nursing home residents whose ability to move independently worsened0.1
People with a usual primary care provider0.3
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms0.3
Home health care patients whose surgical wound was improved0.4
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 care0.5
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 care0.6
Adults who reported that home health providers talked with them about when to take medicines in the last 2 months of care0.6
People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler)0.6
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 needed0.6
Adults with obesity who ever received advice from a health professional about eating fewer high-fat or high-cholesterol foods0.6
Adults who reported getting the help or advice they needed the same day they contacted their home health providers0.6
Short-stay nursing home residents who were assessed for pneumococcal vaccination0.6
Adults who reported getting the help or advice they needed when they contacted their home health providers in the last 2 months of care0.8
People with a specific source of ongoing care0.8
Low-risk, long-stay nursing home residents with loss of control of bowels or bladder0.9
People unable to get or delayed in getting needed medical care due to financial or insurance reasons1.0
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 injury1.4
Mechanical adverse events in adult patients receiving central venous catheter placement2.5
Long-stay nursing home residents who were assessed for pneumococcal vaccination3.2
Hospital patients who received pneumococcal immunization20.0
Measures That Are Worsening
MeasureAverage Annual Percent Change
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 be1.3
People unable to get or delayed in getting needed dental care due to financial or insurance reasons1.4
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
HIV infection deaths per 100,000 population1.8
Suicide deaths among persons age 12 and over per 100,000 population1.8
People who were unable to get or delayed in getting needed medical care in the last 12 months2.1
Adults age 65 and over with any private health insurance2.3
Home health care patients who had an emergency department visit without a hospitalization2.5
People who were unable to get or delayed in getting needed prescription medicines in the last 12 months2.5
Home health care patients who had an emergency department visit and then hospitalized2.5
Drug overdose deaths involving natural and semisynthetic opioids per 100,000 resident population3.0
Drug overdose deaths involving any opioid per 100,000 resident population3.2
People who were unable to get or delayed in getting needed dental care in the last 12 months3.7
Adults who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist3.9
People in fair or poor health with a specific source of ongoing care5.6
Hospital inpatient stays involving opioid-related diagnoses per 100,000 population8.7
Emergency department visits involving opioid-related diagnoses per 100,000 population11.6