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California

Focus on Disparities

How Does the Quality of Care for Individuals Living in Low-Income Communities
Compare to High-Income Communities?


This section describes quality of care for individuals living in low-income communities compared to persons in high-income communities. Individuals in low-income communities in 2006 are defined as patients who resided in ZIP Codes with median annual household incomes of $37,999 and below (this is also the dollar amount below which 25 percent of median annual household incomes fall, i.e., the first income quartile). Patients in high-income communities lived in ZIP Codes with median annual household incomes of $62,000 and above (i.e., the fourth income quartile).



California to U.S. Comparison

Compared to the U.S., the performance for California in quality of care of individuals living in low-income communities compared to persons in high-income communities is in the average range.
The position of the solid arrow represents the State's performance meter score for the most recent data year.

What performance measures make up this meter? (select this link or the Meter)

How are measures represented by a performance meter? (select this link or Methods)

What contextual factors might influence this State's performance? (select this link or Contextual Factors)


The meter above summarizes the California disparity, or "gap," in quality of care of individuals living in low-income communities compared to persons in high-income communities relative to the disparity for the U.S. The performance meter score is based on up to 29 measures of quality of care and is reported only if at least five measures are available. A State receives a stronger performance meter score as the number of measures for which the State is doing better than the U.S. (i.e., disparity in quality of care is smaller) increases. A State receives a weaker performance meter score as the number of measures for which the State is doing worse than the U.S. (i.e., disparity in quality of care is larger) increases.

Compared to the U.S., the performance for California is in the average range.

Disparity in Quality of Ambulatory Care Between Individuals Living in Low-Income and High-Income Communities
These AHRQ Prevention Quality Indicators refer to hospital admissions that evidence suggests could have been avoided, at least in part, through high-quality outpatient care.
Ambulatory Care Measures Relative Rate: CA
Low-Income/High-Income		 Relative Rate Value: CA
Low-Income/High-Income		 Relative Rate: US
Low-Income/High-Income		 Relative Rate Value: US
Low-Income/High-Income		 Comparative Rate:
CA to US		 Comparative Rate Value:
CA to US

 Respiratory Disease
 
Admissions for chronic obstructive pulmonary disease per 100,000 population, age 18 and over indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.26 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.21 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 1.02
Bacterial pneumonia admissions per 100,000 population, age 18 and over indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.63 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.61 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 1.01
Pediatric asthma admissions per 100,000 population, ages 2-17 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.60 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.31 indicates that the State is performing better than the U.S. (i.e., disparity in the State is smaller than in the U.S.) 0.69
Asthma admissions per 100,000 population, age 18 and over indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.36 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.43 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 0.97
Asthma admissions per 100,000 population, age 65 and over indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.69 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.39 indicates that the State is performing worse than the U.S. (i.e., disparity in the State is larger than in the U.S.) 1.21
Immunization-preventable influenza admissions per 100,000 population, age 65 and over indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 0.82 indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 0.92 indicates that the State is performing better than the U.S. (i.e., disparity in the State is smaller than in the U.S.) 0.89

 Heart Disease
 
Admissions for hypertension per 100,000 population, age 18 and over indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.52 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.57 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 0.98
Admissions for congestive heart failure per 100,000 population, age 18 and over indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.93 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.72 indicates that the State is performing worse than the U.S. (i.e., disparity in the State is larger than in the U.S.) 1.12
Admissions for angina without procedure per 100,000 population, age 18 and over indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.34 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.36 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 0.99

 Diabetes
 
Admissions for diabetes with short-term complications per 100,000 population, ages 6-17 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.26 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.16 indicates that the State is performing better than the U.S. (i.e., disparity in the State is smaller than in the U.S.) 0.58
Admissions for diabetes with short-term complications per 100,000 population, age 18 and over indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.42 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.65 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 0.91
Admissions for diabetes with long-term complications per 100,000 population, age 18 and over indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.71 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.24 indicates that the State is performing worse than the U.S. (i.e., disparity in the State is larger than in the U.S.) 1.21
Admissions for uncontrolled diabetes without complications per 100,000 population, age 18 and over indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 3.97 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 4.17 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 0.95
Lower extremity amputations among patients with diabetes per 100,000 population, age 18 and over indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.48 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 2.29 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 1.08

Disparity in Quality of Hospital Care Between Individuals Living in Low-Income and High-Income Communities
These AHRQ Inpatient Quality Indicators and Patient Safety Indicators refer to inpatient deaths and potentially avoidable complications.
Hospital Care Measures Relative Rate: CA
Low-Income/High-Income		 Relative Rate Value: CA
Low-Income/High-Income		 Relative Rate: US
Low-Income/High-Income		 Relative Rate Value: US
Low-Income/High-Income		 Comparative Rate:
CA to US		 Comparative Rate Value:
CA to US

 Hospital Mortality
 
Deaths per 1,000 admissions with abdominal aortic aneurysm (AAA) repair indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 1.41 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.14 indicates that the State is performing worse than the U.S. (i.e., disparity in the State is larger than in the U.S.) 1.24
Deaths per 1,000 admissions with coronary artery bypass surgery (CABG), age 40 and over indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 1.03 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.21 indicates that the State is performing better than the U.S. (i.e., disparity in the State is smaller than in the U.S.) 0.85
Deaths per 1,000 discharges for acute myocardial infarction (AMI) indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 1.03 indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 1.08 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 0.95
Deaths per 1,000 adult admissions with congestive heart failure (CHF) indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 0.91 indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 1.08 indicates that the State is performing better than the U.S. (i.e., disparity in the State is smaller than in the U.S.) 0.84
Deaths per 1,000 adult admissions with pneumonia indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 1.10 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.11 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 0.99
Deaths per 1,000 adults with percutaneous transluminal coronary angioplasty (PTCA), age 40 and over indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 1.10 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.19 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 0.93

 Hospital Safety
 
Deaths per 1,000 admissions in low-mortality DRGs indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.50 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.34 indicates that the State is performing worse than the U.S. (i.e., disparity in the State is larger than in the U.S.) 1.12
Iatrogenic pneumothorax per 1,000 discharges indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 0.88 indicates that lowest income communities receive better quality of care or have better outcomes (i.e., have fewer preventable admissions) than highest income communities. 0.90 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 0.99
Selected infections due to medical care per 1,000 discharges indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 0.94 indicates that lowest income communities receive better quality of care or have better outcomes (i.e., have fewer preventable admissions) than highest income communities. 0.85 indicates that the State is performing worse than the U.S. (i.e., disparity in the State is larger than in the U.S.) 1.10
Postoperative septicemia per 1,000 elective surgical discharges of 4 or more days indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.56 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.16 indicates that the State is performing worse than the U.S. (i.e., disparity in the State is larger than in the U.S.) 1.34
Postoperative abdominal wound dehiscence per 1,000 discharges indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.84 indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities. 1.18 indicates that the State is performing worse than the U.S. (i.e., disparity in the State is larger than in the U.S.) 1.56

 Hospital Birth/ Obstetrics
 
Birth trauma injury to neonate per 1,000 selected live births indicates that lowest income communities receive better quality of care or have better outcomes (i.e., have fewer preventable admissions) than highest income communities. 0.55 indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities. 1.02 indicates that the State is performing better than the U.S. (i.e., disparity in the State is smaller than in the U.S.) 0.54
Obstetric trauma per 1,000 instrument-assisted deliveries indicates that lowest income communities receive better quality of care or have better outcomes (i.e., have fewer preventable admissions) than highest income communities. 0.70 indicates that lowest income communities receive better quality of care or have better outcomes (i.e., have fewer preventable admissions) than highest income communities. 0.70 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 1.01
Obstetric trauma per 1,000 vaginal deliveries without instrument assistance indicates that lowest income communities receive better quality of care or have better outcomes (i.e., have fewer preventable admissions) than highest income communities. 0.71 indicates that lowest income communities receive better quality of care or have better outcomes (i.e., have fewer preventable admissions) than highest income communities. 0.69 indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.) 1.03
Obstetric trauma per 1,000 Cesarean deliveries indicates that lowest income communities receive better quality of care or have better outcomes (i.e., have fewer preventable admissions) than highest income communities. 0.52 indicates that lowest income communities receive better quality of care or have better outcomes (i.e., have fewer preventable admissions) than highest income communities. 0.75 indicates that the State is performing better than the U.S. (i.e., disparity in the State is smaller than in the U.S.) 0.70


Direction of Disparity:
indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities.indicates that lowest income communities receive poorer quality of care or have worse outcomes (i.e., have more preventable admissions) than highest income communities.
indicates that lowest income communities receive better quality of care or have better outcomes (i.e., have fewer preventable admissions) than highest income communities.indicates that lowest income communities receive better quality of care or have better outcomes (i.e., have fewer preventable admissions) than highest income communities.
indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities.indicates that lowest income communities receive the same quality of care and have similar outcomes (i.e., have a similar number of preventable admissions) as highest income communities.

The symbols are based on statistical significance and a differential of at least 10 percent.

State to U.S. Comparison of Disparity:
indicates that the State is performing better than the U.S. (i.e., disparity in the State is smaller than in the U.S.)indicates that the State is performing better than the U.S. (i.e., disparity in the State is smaller than in the U.S.)
indicates that the State is performing worse than the U.S. (i.e., disparity in the State is larger than in the U.S.)indicates that the State is performing worse than the U.S. (i.e., disparity in the State is larger than in the U.S.)
indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.)indicates that the State is performing similar to the U.S. (i.e., disparity in the State is similar to the U.S.)

The symbols are based on a differential of at least 10 percent.
DSU:  Data do not meet the criteria for statistical reliability, data quality, or confidentiality.
DNC:  Data were not collected.

Relative Rates:
A relative rate above 1.0 indicates the lowest income communities have worse outcomes or receive poorer quality of care than the highest income communities; the higher the value, the greater the disparity. A relative rate less than 1.0 indicates the lowest income communities have better outcomes or receive better quality of care than the highest income communities.
Comparative Rate:
In the comparison of the State to the U.S., a value above 1.0 indicates that the State is doing worse than the U.S. in terms of the disparity in quality of care of individuals living in low-income communities. A value below 1.0 indicates that the State is doing better than the U.S. in terms of the disparity in quality of care of individuals living in low-income communities. A relative rate of 1.1 or above is reported as "worse" and a relative rate of 0.9 or below is reported as "better" in the graphics.