NationalResidents of Rural Areas 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-20.5
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-17.4
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined-13.6
Adolescents ages 16-17 who received 1 or more doses of meningococcal conjugate vaccine-13.3
Adolescents ages 13-15 who received 1 or more doses of meningococcal conjugate vaccine-11.8
Adolescent males ages 16-17 who received 3 or more doses of human papillomavirus (HPV) vaccine-6.5
Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis-6.1
Adolescent males ages 13-15 who received 3 or more doses of human papillomavirus (HPV) vaccine-5.3
Infants born in the calendar year who received breastfeeding through 3 months-5.0
HIV infection deaths per 100,000 population-4.8
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-4.7
Children ages 0-17 with wellness checkup in the past 12 months-4.7
People with a specific source of ongoing care-4.0
Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults-3.8
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-3.8
Adolescents females ages 16-17 who received 3 or more doses human papillomavirus vaccine-3.5
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
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)-3.3
Children who had their height and weight measured by a health provider within the past 2 years-3.2
People under age 65 with health insurance-3.2
People with a usual source of care who usually asks about prescription medications and treatments from other doctors-3.0
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-2.8
Adolescents females ages 13-15 who received 3 or more doses human papillomavirus vaccine-2.8
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-2.7
Adults age 65 and over who ever received pneumococcal vaccination-2.7
People who were unable to get or delayed in getting needed dental care in the last 12 months-2.5
People unable to get or delayed in getting needed medical care due to financial or insurance reasons-2.0
People unable to get or delayed in getting needed prescription medicines due to financial or insurance reasons-1.8
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-1.7
Lung cancer deaths per 100,000 population per year-1.6
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-1.6
Children ages 3-5 who ever had their vision checked by a health provider-1.6
Adults ages 18-64 at high risk (e.g., COPD) who ever received pneumococcal vaccination-1.5
Colorectal cancer deaths per 100,000 population per year-1.4
Adults with obesity who ever received advice from a health professional to exercise more-1.3
Children ages 2-17 for whom a health provider gave advice within the past 2 years about eating healthy-1.3
Breast cancer deaths per 100,000 female population per year-1.2
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-1.1
Measures That Are Unchanged
MeasureAverage Annual Percent Change
Adults who filled four or more outpatient opioid prescriptions in the calendar year-3.6
People in fair or poor health with a specific source of ongoing care-3.0
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 treatment-2.6
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-2.2
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-2.0
Adults who filled an outpatient opioid prescription in the calendar year-2.0
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-1.9
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year-1.7
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-1.6
Adults age 40 and over with diagnosed diabetes who received a flu vaccination in the calendar year-1.6
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 treatment-1.5
Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high-1.4
People who were unable to get or delayed in getting needed prescription medicines in the last 12 months-1.3
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-1.1
Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months-1.1
People under age 65 whose family's health insurance premium and out-of-pocket medical expenditures were more than 10% of total family income-1.1
People under age 65 who were uninsured all year-0.9
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-0.8
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year-0.8
Adults age 65 and over who received an influenza vaccination in the last flu season-0.6
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-0.6
Adult current smokers with a checkup in the last 12 months who received advice to quit smoking-0.4
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-0.3
Adults with obesity who ever received advice from a health professional about eating fewer high-fat or high-cholesterol foods-0.3
People who were unable to get or delayed in getting needed medical care in the last 12 months-0.2
Live-born infants with low birth weight (less than 2,500 g)-0.2
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c measurements in the calendar year-0.1
People with a usual source of care who is somewhat to very difficulty to contact during regular business hours over the telephone-0.0
Children ages 2-17 who had a dental visit in the calendar year-0.0
Children ages 12-17 with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months-0.0
Children for whom a health provider gave advice within the past 2 years about how smoking in the house can be bad for a child0.0
Children ages 2-17 who received a preventive dental service in the calendar year0.1
People under age 65 with any period of uninsurance during the year0.2
Adults with chronic joint symptoms who have ever seen a doctor or other health professional for joint symptoms0.2
People with a usual primary care provider0.3
Adults who received a preventive dental service in the calendar year0.4
Adults who had a doctor's office or clinic visit in the last 12 months whose health providers always offered help in filling out forms0.4
People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends0.6
Adults with a dental visit in the calendar year0.6
People without a usual source of care who indicated a financial or insurance reason for not having a source of care0.8
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 needed1.0
Infant mortality per 1,000 live births, birth weight 2,500 grams or more1.1
Women ages 50-74 who received a mammogram in the last 2 years1.2
Children who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist4.7
Adults who needed to see a specialist in the last 12 months who sometimes or never found it easy to see a specialist4.9
Measures That Are Worsening
MeasureAverage Annual Percent Change
People unable to get or delayed in getting needed dental care due to financial or insurance reasons1.1
People under age 65 with any private health insurance1.3
People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler)1.3
Adults age 65 and over with any private health insurance1.5
Suicide deaths among persons age 12 and over per 100,000 population2.8
Women ages 21-65 who received a Pap smear in the last 3 years3.7
Hospital inpatient stays involving opioid-related diagnoses per 100,000 population8.6
Emergency department visits involving opioid-related diagnoses per 100,000 population10.1
Drug overdose deaths involving any opioid per 100,000 resident population10.9
Drug overdose deaths involving natural and semisynthetic opioids per 100,000 resident population11.3
Drug overdose deaths involving other synthetic opioids (other than methadone) per 100,000 resident population15.9
Children ages 2-19 who visited emergency department for asthma62.5