NQS Priority #1: Making Care Safer by Reducing the Harm Caused in the Delivery of Care

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1 NQS Priority #: Making Care Safer by Reducing the Harm Caused in the Delivery of Care Measure: Hospital-acquired Conditions (HAC) Incidence of measurable hospital-acquired conditions 45 HACs per,000 admissions Reduce preventable HACs by 40% by the end of 03 Measure: Hospital-acquired Conditions NOTE: In each baseline cell, the first line indicates the observed rate per 00,000 population, and the number in parentheses () on the second line indicates the total number of cases statewide. Accidental Puncture or Laceration 9.6 (8,30) 7.8 Postoperative Hemorrhage or Hematoma Central Venous Catheter-related Bloodstream Infections.8 (3,565).6 (3,) Iatrogenic Pneumothorax Postoperative Wound Dehiscence Source: Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, and Centers for Medicare and Medicaid Services, March 0. Source: OSHPD Patient Discharge Data, 009; Agency for Healthcare Research and Quality, Patient Safety Indicators, Version 4.., County Level Data available Let s Get Healthy Task Force 5.6 (,566).4 (395)

2 NQS Priority #: Making Care Safer by Reducing the Harm Caused in the Delivery of Care Measure: Hospital Readmissions All-payer 30-day readmission rate* * Executive Order/ Quality Strategy shared priority Measures: Hospital Readmissions 4.4% % by the end of Hospital 30-day Readmission Rates for Top 5 Conditions Description Source: Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, and Centers for Medicare and Medicaid Services, March 0. OSHPD Patient Discharge Data, 00, County Level Data Available Let s Get Healthy Task Force No. Patients w/ 30-day Readmission Readmission Rate % Septicemia or Severe Sepsis 5, Pneumonia 9,40 6. Heart Failure 9, Esophagitis & Gastroenteritis 6, COPD & Asthma 5, % by the end of 05 3% by the end of 05 0% by the end of 05 % by the end of 05 % by the end of 05

3 NQS Priority #: Ensuring That Each Person and Family is Engaged in Their Care Measure: Timely Care Adults who needed care right away for an illness, injury, or condition in the last months who sometimes or never got care as soon as wanted 4.% None Set Measures: Timely Care Survey How often were you able to get an appointment within two days? Would you say CHIS Adult Survey Data Forthcoming None Set Source: Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends, Medical Expenditure Panel Survey, 009. Health Interview Survey: Large county data level available; Small county level data may be available Let s Get Healthy Task Force 3

4 NQS Priority #: Ensuring That Each Person and Family is Engaged in Their Care Measure: Decision-Making People with a usual source of care whose health care providers sometimes or never discuss decisions with them 5.4% None Set Measure: Decision-Making Survey How often does your doctor or medical provider explain clearly what you need to do to take care of your health? Would you say CHIS Adult Survey Data Forthcoming None Set Source: Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends, Medical Expenditure Panel Survey, 009. Health Interview Survey: Large county level data available; Small county level data may be available Let s Get Healthy Task Force 4

5 NQS Priority #3: Promoting Effective Communication and Coordination of Care Measure: Patient-Centered Medical Home Percentage of children needing care coordination who receive effective care coordination. 69% None Set Measures: Patient-Centered Survey Medical Home Is there anyone at your doctor s office or clinic who helps coordinate your care with other doctors or services, such as tests or treatments? CHIS Adolescent Survey 67.% - Yes 94% Is there anyone at (CHILD s) doctor s office or clinic who helps CHIS Child coordinate (his/her) care with other doctors or services such as Survey tests or treatments? 63.9% - Yes 90% Source: Health Resources and Services Administration, Maternal and Child Health Bureau; Centers for Disease Control and Prevention, Center for Health Statistics, Survey of Children's Health, 007. Health Interview Survey: Large county level data available; Small county level data may be available Let s Get Healthy Task Force 5

6 NQS Priority #4: Promoting the Most Effective Prevention and Treatment Practices for the Leading Causes of Mortality, Starting with Cardiovascular Disease Measure: Blood Pressure Control People with hypertension who have adequately controlled blood pressure* * Executive Order/ Quality Strategy shared priority 46% 65% by 07 Measure: Blood Pressure Control Survey Controlling High Blood Pressure - Adults (8-85yrs) diagnosed with hypertension* * Executive Order/ Quality Strategy shared priority HEDIS Medicare - 79% PPOs - 50% HMOs - 78% Medicare - 87% PPOs - 70% HMOs - 86% Source: Centers for Disease Control and Prevention, Health and Nutrition Examination Survey (NHANES), Statewide and Health Plan Specific Data Let s Get Healthy Task Force 6

7 NQS Priority #4: Promoting the Most Effective Prevention and Treatment Practices for the Leading Causes of Mortality, Starting with Cardiovascular Disease Measure: Cholesterol Management People with high cholesterol who have adequately managed hyperlipidemia 33% 65% by 07 Measure: Cholesterol Management Survey Cholesterol Management Cardiovascular Conditions LDL-C <00 mg/dl HEDIS Medicare - 76% PPOs - 50% HMOs - 70% Medicare - 9% PPOs - 70% HMOs - 84% Source: Centers for Disease Control and Prevention, Health and Nutrition Examination Survey (NHANES), Statewide and Health Plan Specific Data Let s Get Healthy Task Force 7

8 NQS Priority #4: Promoting the Most Effective Prevention and Treatment Practices for the Leading Causes of Mortality, Starting with Cardiovascular Disease Measure: Aspirin Use People at increased risk of cardiovascular disease who are taking aspirin 47% 3 65% by 07 Measure: Aspirin Use Survey What percentage of women, ages 55-79, and men, ages 45-79, who have cardiovascular risks, had their doctor or another provider talk with them about the pros and cons of taking aspirin as part of their heart care? HEDIS Data Forthcoming N/A Statewide and Health Plan Specific Data Available 3 Source: Centers for Disease Control and Prevention, Ambulatory Medical Care Survey (NAMCS) and Hospital Ambulatory Medical Care Survey (NHAMCS), Let s Get Healthy Task Force 8

9 NQS Priority #5: Working with Communities to Promote Wide Use of Best Practices to Enable Healthy Living Measure: Depression Percentage of adults reported symptoms of a major depressive episode (MDE) in the last months who received treatment for depression in the last months 68.3% None Set Measure: Depression Survey What percentage of those who were treated for depression remained on anti-depressant medication for 6 months of ongoing care following their initial treatment? HEDIS 47.3% % Source: Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Survey on Drug Use and Health, 00 Statewide and Health Plan Specific Data Available 3 CA HMO/PPO Combined Average. Let s Get Healthy Task Force 9

10 Additional Measures: Reducing Potentially Avoidable Hospitalizations Reducing Potentially Avoidable Hospitalizations - Adults Source NOTE: In each baseline cell, the first line indicates the age-sex adjusted rate per 00,000 state population, and the number in parentheses () on the second line indicates the total number of cases. Congestive Heart Failure 7.4 (73,3) 7.9 Bacterial Pneumonia AHRQ Prevention Quality Indicators 35.8 (64,85) Diabetes Indicators 94.8 (54,633) Adult Asthma 87.3 (4,386) 69.8 This represents the combined values of the following indicators: Diabetes Short Term Complications, Diabetes Long Term Complications, Uncontrolled Diabetes, and Lower-extremity Amputation Among Patients with Diabetes. Source: OSHPD Patient Discharge Data, 009; Agency for Healthcare Research and Quality, Prevention Quality Indicators, Version 4.., County Level Data Available Let s Get Healthy Task Force 0

11 Additional Measures: Reducing Potentially Avoidable Hospitalizations Reducing Potentially Avoidable Hospitalizations - Children Source NOTE: In each baseline cell, Rate = Per 00,000 state or county population with the exceptions of Pediatric Perforated Appendix (per,000 appendicitis cases) and Low Birth Weight (per,000 live births). The number in parentheses () on the second line indicates the total number of cases. All rates are age-sex adjusted (with the exception of Low Birth Weight). Pediatric Asthma (per 00,000 population) Pediatric Gastroenteritis (per 00,000 population) Pediatric Urinary Tract Infection (per 00,000 population) Pediatric Diabetes Short-term Complications (per 00,000 population) AHRQ Pediatric Quality Indicators 99. (8,689) 7.3 (7,0) 35. (3,405) 0. (,378) Pediatric Perforated Appendix (per,000 appendicitis cases) Low Birth Weight (per,000 live births) 94.0 (4,6) 56. (9,06) Source: OSHPD Patient Discharge Data, 009; Agency for Healthcare Research and Quality, Pediatric Quality Indicators, Version 4. County Level Data Available Let s Get Healthy Task Force

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