Step-by-Step User's Guide
The State Snapshots, produced annually by the Agency for Healthcare Research and Quality, provide State-specific quality information, including strengths, weaknesses, and opportunities for improvement. The goal is to help State officials and their public- and private-sector partners better understand health care quality and disparities in their State. This section provides step-by-step instructions for using the State Snapshots online.
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Overview
State-level information used to create the State Snapshots is based on data collected for the National Healthcare Quality Report (NHQR). AHRQ produces this report to monitor improvements in health care quality across the country and to provide benchmarks against which improvement can be measured.
As in the NHQR, information on health care quality measures for each State in the State Snapshots focuses on measures of effectiveness, patient safety, timeliness, and patient centeredness. This section provides instructions for accessing the State Snapshots online and highlights the relevant links, resources, and data tables for each section of the State Snapshots site.
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How To Use the State Snapshots
2007 State Snapshots Home
On the State Snapshots home page, the navigation bar on the left side of the screen gives the overall contents (Figure 1). As you move between various sections, this toolbar expands, indicating which section of the Snapshots you are currently accessing.
Figure 1. Home page navigation bar
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1. Select State Selection Map
To begin, select the State Selection Map, either from the left navigation bar or the State Selection Map link on the home page.
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2. Select Your State of Interest
From the State Selection Map, you can choose a State of interest by selecting from:
- A drop-down menu with States listed alphabetically, or
- A map of the United States.
Example: Select a State. You will go to the State Dashboard page that displays the overall health care quality performance meter for the State compared to all reporting States and 12 meters summarizing health care quality in three broad areas: types of care, settings of care, and care by clinical area. Once you select a State, any pages you view will show information for that State until you select a different State. For example, if you select Texas, any pages you view will pertain to Texas until you make a change.
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3. Select State Dashboard
The State Dashboard compiles all the summary meters in one place. It provides an overview of the selected State's performance compared to all States in overall health care quality and on subsets of measures related to types of care, settings of care, and care by clinical area. By visiting the State Dashboard, you can quickly gain an understanding of your State's performance. To learn more about performance on particular measures, visit the applicable sections of the Web site by using the left navigation bar.
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4. Select Overall Health Care Quality
a. Compare State With All States
- Example: The State Overall Health Care Quality page displays a meter answering these questions: “What is the overall health care quality performance compared to all States?” and “How has that performance changed?” For example, the arrows on the meter below display the State's overall performance compared to all States. The solid arrow represents the most recent data year; the dashed arrow represents the baseline year.
- The solid arrow is in the “average” range. Compared to all States, the State is “average” on measures for the most recent data year.
- The dashed arrow is in the “average” range. Compared to all States, the State is “average” on all measures for the baseline year.
- Because the solid arrow is to the right of the dashed arrow, the State's performance compared to all States has improved from the baseline to the most recent data year.
- To determine the approximate number of years between the most recent data year and the baseline year, click on the meter and scan the years in the table of measures for the summary meter. The number of years may vary from measure to measure for a meter.
- Note: To view individual measures, select the meter icon or a link under the meter called, “What performance measures make up this meter?” A table will appear with data on all the health care quality measures that make up this meter for this State. Measures for which the State is “Better than Average,” “Average,” and “Worse than Average” are grouped together.
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b. Compare State With Region
- Example: From the State's Overall Health Care Quality page, select the link to the State's region in the “My State Compared to” box in the upper right corner of the screen. For example, examine the arrows on the meter below to learn how the State's overall performance compares with that of its region. The solid arrow represents the most recent data year; the dashed arrow represents a baseline year.
- The solid arrow is in the “average” range. Compared to its region, the State is “average” in measures for the most recent data year.
- The dashed arrow is also in the “average” range.
- Because the dashed arrow is very close to the solid arrow, the State's performance in the most recent data year compared to the baseline data year essentially has not changed.
- To determine the approximate number of years between the most recent data year and the baseline year, click on the meter and scan the years in the table of measures for the summary meter. The number of years may vary from measure to measure for a meter.
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c. Compare State With Best Performing States
- Example: From the State's Overall Health Care Quality page, select the “Best Performing States” link in the “My State Compared to” box in the upper right corner of the screen. You will go to a table that presents the State's overall score and the scores of the five States with the highest scores in overall health care. Examine the table to learn how the State compares to the best performing States on all health care measures. The State's score is listed in the first row.
After selecting a State, you can use additional options for reviewing data on the navigation bar. These options are discussed in steps 5-13.
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5. Select Strongest and Weakest Measures
This page lists the best and worst performing measures in the State of interest for the given year. At least five of these measures are listed, more if the fifth measure is tied with others of identical value.
- Example: Select “Strongest and Weakest Measures” on the left navigation bar. A page will appear that lists the State's strongest and weakest measures relative to all States.
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6. Select Types of Care
These pages provide information on how the selected State performs on a number of health care measures related to preventive care (or staying healthy), acute care (or getting better), and chronic care (or living with illness) (Figure 2).
Figure 2. Home page navigation bar, Types of Care expanded
- Example: Select “Types of Care” on the navigation bar. Then select “Preventive Care.” A meter will appear indicating how providers in the State perform on preventive measures compared to all reporting States. For example, examine the arrows on the meter below. The solid arrow represents the most recent data year; the dashed arrow represents the baseline year.
- The solid arrow indicates that the State's overall performance in preventive care compared to all reporting States is “strong.”
- The dashed arrow is also in the “strong” range.
- Because the dashed and solid arrows are at the same level, the State's performance in preventive care has not changed from the baseline year to the most recent data year.
- To determine the approximate number of years between the most recent data year and the baseline year, click on the meter and scan the years in the table of measures for the summary meter. The number of years may vary from measure to measure for a meter.
- Note: To compare the State's preventive care performance within its region, follow the instructions in step 4b above. To compare the State's preventive care performance with that of the best performing States, follow the instructions in step 4c above.
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7. Select Settings of Care
These pages provide information on how the selected State performs in a number of health care settings—hospital care, ambulatory care, nursing home care, and home health care (Figure 3).
Figure 3. Home page navigation bar, Settings of Care expanded
- Example: Select “Settings of Care” on the navigation bar. Then select “Hospital Care.” A meter will appear indicating how providers in the State perform on hospital care measures compared to all reporting States. For example, examine the arrows on the meter below. The solid arrow represents the most recent data year; the dashed arrow represents a baseline year.
- The solid arrow indicates that the State's overall performance in hospital care compared to all States is “strong.”
- The dashed arrow on the meter for the baseline year is not displayed because there were insufficient data to show baseline performance.
- Note: To compare the State's hospital care performance within its region, follow the instructions in step 4b above. If you would like to compare the State's hospital care performance with that of the best performing States, follow the instructions in step 4c above.
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8. Select Care by Clinical Area
These pages provide information on how the selected State performs in five clinical areas: cancer, diabetes, heart disease, maternal and child health, and respiratory diseases (Figure 4).
Figure 4. Home page navigation bar, Care by Clinical Area expanded
- Example: Select “Care by Clinical Area” on the navigation bar. Then select “Cancer.” A page will appear with a meter indicating how the State's cancer care performance compared to all reporting States. For example, examine the arrows on the meter below. The solid arrow represents the most recent data year; the dashed arrow represents the baseline year.
- The solid arrow indicates that the State's overall performance in cancer care compared to all States is “average.”
- The dashed arrow is also in the “average” range.
- Because the solid arrow is slightly to the right of the dashed arrow, the State's performance in cancer care improved slightly from the baseline year to the most recent data year.
- To determine the approximate number of years between the most recent data year and the baseline year, click on the meter and scan the years in the table of measures for the summary meter. The number of years may vary from measure to measure for a meter.
- Note: To compare the State's cancer care performance within its region, follow the instructions in step 4b above. To compare the State's cancer care performance with that of the best performing States, follow the instructions in step 4c above.
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9. Select Focus on Diabetes
These pages provide information on how the selected State performs on a set of diabetes measures. The diabetes measures include: quality of diabetes care (for processes and outcomes of diabetes care); disparities in diabetes treatment (by income and race/ethnicity); lives and expenses; and excess costs of diabetes (Figure 5).
Figure 5. Home page navigation bar, Focus on Diabetes expanded
Quality of Diabetes Care
- Example: From “Focus on Diabetes” on the left navigation bar or from the main page of “Focus on Diabetes,” select “Quality of Diabetes Care-Processes of Care.” A page with a meter will appear indicating how the State's performance on process-of-care measures for diabetes compared to all reporting States. For example, examine the arrows on the meter below. The solid arrow represents the most recent data year; the dashed arrow represents a baseline year.
- The solid arrow indicates that the State's overall performance on diabetes processes of care compared to all States is “average.”
- The dashed arrow indicates that the State's overall performance on diabetes processes of care compared to all States is “average” for the baseline year.
- Because the most recent and baseline arrows are at the same level, the State's performance has not changed from the baseline year to the most recent data year.
- To determine the approximate number of years between the most recent data year and the baseline year, click on the meter and scan the years in the table of measures for the summary meter. The number of years may vary from measure to measure for a meter.
- Example: From “Focus on Diabetes” on the left navigation bar or from the main page of “Focus on Diabetes,” select “Quality of Diabetes Care-Outcomes of Care.” A bar graph will appear showing how the State's hospitalization rates for complications related to diabetes compare to the regional average and the all-State average.
Disparities in Diabetes Treatment
- Example: From “Focus on Diabetes” on the left navigation bar or from the main page of “Focus on Diabetes,” select “Disparities in Diabetes Treatment-by Income.” A national map will appear that highlights how the State's hemoglobin A1c (HbA1c) testing rates compare for low-income and high-income groups.
- Example: From “Focus on Diabetes” on the left navigation bar or from the main page of “Focus on Diabetes,” select “Disparities in Diabetes Treatment-by Race/Ethnicity.” A national map will appear that highlights how the State's HbA1c testing rates compare between Blacks and Whites.
Lives and Expenses
- Example: From “Focus on Diabetes” on the navigation bar or from the main page of “Focus on Diabetes,” select “Lives and Expenses.” A bar graph will appear that highlights the State's estimated share of health expenditures on State government employees for diabetes-related care.
Excess Costs of Diabetes
- Example: From “Focus on Diabetes” on the navigation bar or from the main page of “Focus on Diabetes”, select “Excess Costs of Diabetes.” A page will appear with information on potential savings that might result from a diabetes quality improvement program.
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10. Select Focus on Healthy People 2010
A data table will appear that features the State's performance on measures included in the Healthy People 2010 initiative of the U.S. Department of Health and Human Services. The measures belong to categories of Leading Health Indicators that are used to help identify and set national goals for reducing preventable disease and to measure the Nation's performance.
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11. Select Focus on Clinical Preventive Services
The performance meter on this page indicates the selected State's performance on clinical preventive services recommended by the U.S. Preventive Services Task Force and the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practice. These two expert bodies use the best research evidence available to make recommendations on preventive services for people without symptoms of disease.
- Example: Select “Focus on Clinical Preventive Services” on the left navigation bar. A meter will appear indicating how providers in the State perform on clinical preventive services compared to all reporting States. For example, examine the arrows on the meter below. The solid arrow represents the most recent data year; the dashed arrow represents the baseline year.
- The solid arrow indicates that the State's overall performance in clinical preventive services compared to all States is “strong.”
- The dashed arrow is also in the “strong” range.
- The solid arrow is to the left of the dashed line, indicating that the State's performance may have deteriorated from the baseline year, although the change is slight.
- To determine the approximate number of years between the most recent data year and the baseline year, click on the meter and scan the years in the table of measures for the summary meter. The number of years may vary from measure to measure for a meter.
- Note: To compare the State's clinical preventive services performance within its region, follow the instructions in step 4b above. To compare the State's clinical preventive services performance with the best performing States, follow the instructions in step 4c above.
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12. Select State Rankings for Selected Measures
This page shows how well the State of interest is performing relative to all States on selected measures from the 2007 National Healthcare Quality Report.
- Example: Select “State Rankings for Selected Measures” on the left navigation bar. A table will appear with the all-State average rate, the State rate, and the State's rank among all States and the District of Columbia for 15 important quality measures.
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13. Select Contextual Factors
This page displays dials on how the selected State compares to all States on 13 factors that represent the State's context or environment related to demographics of its population, health status of the population, and health care resources. The dials may aid in interpreting the State's performance on health care quality.
- Example: Select “Contextual Factors” on the left navigation bar. Dials will appear for 13 contextual factors. For example, examine the dial below.
The black arrow (on top of the orange wedge) represents the State's value (a percent or rate) for the factor selected. The orange wedge shows the spread of values across all the States. The side of the wedge with the lowest value represents the State with the lowest value on the factor. The side with the highest value represents the State with the highest value.
- Note: To compare the State's contextual factors with those of its region, select the region link in the “My State Compared to” box in the upper right corner of the screen.
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14. All-State Data Tables for All Measures
This page allows you to download a data table that includes all measures for all States from the 2007 National Healthcare Quality Report and a data table including contextual factors for all States. Both data tables are downloadable in either Excel or XML format.
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15. Snapshot Print Version
This page provides the 2007 State Snapshot PDFs, which assemble for each State all available data represented on this Web site for that State in a format that can be printed easily. The PDF files are in Adobe Acrobat format.
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16. Other State Snapshot Years
This page provides links to State Snapshot data for other years.
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For Additional Information
- Select Interpretation of Results on the left navigation bar for additional information on data and performance measurement issues, including types of measures available and factors that might affect performance rates.
- Select Methods on the left navigation bar if you want more details on how AHRQ develops the State Snapshot summary measures, classifies and scores State performance, and derives the calculations used in developing the measures.
- Select Technical Assistance on the left navigation bar for e-mail and Web site addresses to get help in using this tool or to send questions or comments about the State Snapshots.
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