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California

Hospital Care Quality Measures and Metrics Compared to All States

State Performance Ratings

Rating Number of Measures for State in Summary Measure Number of Measures for All States in Summary Measure
Better than Average = The State rate on an NHQR measure is better than the all-State/regional average and is statistically different from the all-State/regional average. 7 391
Average = The State rate on an NHQR measure is not statistically different from the all-State/regional average. 8 452
Worse than Average = The State rate on an NHQR measure is worse than the all-State/regional average and is statistically different from the all-State/regional average. 16 466
N/A = An estimate or standard error was not available for a State measure or the relative standard error is greater than or equal to 30 percent. 0 272
Total number of measures for the State (excluding measures that are N/A) 31 1309

Measures for which California's rate is Better than the all-State Average

Quality Dimension Short Measure Name State Performance1 Most Recent Data Year State Rate All-State Average2 Regional Average Baseline Year Average Annual Change3 Direction of Change Data Source4 Full NHQR Measure Title NHQR Table Number5
Heart Disease Heart failure - ACEI/ARB at discharge Better than Average 2007 91 90.0 91.1 2005 4.5% Improved QIO Percentage of hospital patients with heart failure and left ventricular systolic dysfunction who were prescribed ACE inhibitor or ARB at discharge 4_3_3.2
Heart Disease Coronary artery bypass graft deaths in hospital Better than Average 2006 22.9 25.9 25.5 2000 -8.7% Improved HCUP Deaths per 1,000 adult admissions ages 40 and over with coronary artery bypass graft (excluding obstetric admissions and transfers to another hospital) 4_4_2.3
Maternal and Child Health Birth trauma injury to neonate per 1,000 live births Better than Average 2006 1.54 1.8 1.6 2004 -5.1% Improved HCUP Birth trauma - injury to neonate per 1,000 live births (excluding preterm and osteogenesis imperfecta births) 6_2_1.3
Maternal and Child Health Obstetric trauma per 1,000 vaginal deliveries without instrument assistance Better than Average 2006 32.5 35.9 33.8 2000 -4.0% Improved HCUP Obstetric trauma with 3rd or 4th degree lacerations per 1,000 vaginal deliveries without instrument assistance 6_2_2.3
Maternal and Child Health Obstetric trauma per 1,000 instrument-assisted deliveries Better than Average 2006 131.5 158.1 140.2 2000 -3.1% Improved HCUP Obstetric trauma with 3rd or 4th degree lacerations per 1,000 instrument-assisted vaginal deliveries 6_2_3.3
Maternal and Child Health Obstetric trauma per 1,000 cesarean deliveries Better than Average 2006 3.14 3.6 3.4 2000 -1.9% Improved HCUP Obstetric trauma with 3rd or 4th degree lacerations per 1,000 cesarean deliveries 6_2_4.3
Timeliness Heart attack - fibrinolytic medication within 30 minutes Better than Average 2007 60.6 50.5 58.6 2005 17.8% Improved QIO Percentage of hospital patients with heart attack who received fibrinolytic medication within 30 minutes of arrival 13_2_4.2


1 State Performance is for the most recent data year compared to All States

2 These all-State averages are calculated consistently across all measures and differ slightly from those in the National Healthcare Quality Report. For more information, select the Methods page.

3 The sign on entries under the column "Average Annual Change" indicates whether the measure has risen or fallen since the baseline year. Because "+" or "-" can represent an improvement or a worsening depending on how the measure is constructed, the column "Direction of Change" helps the user know what the change means.

4 Additional information about data sources/acronyms.

5 Select for other States' rates.

Measures for which California's rate is similar to the all-State Average

Quality Dimension Short Measure Name State Performance6 Most Recent Data Year State Rate All-State Average7 Regional Average Baseline Year Average Annual Change8 Direction of Change Data Source9 Full NHQR Measure Title NHQR Table Number10
Heart Disease Heart attack - ACEI or ARB at discharge Average 2007 91.8 91.8 92.2 2005 4.5% Improved QIO Percentage of hospital patients with heart attack and left ventricular systolic dysfunction who were prescribed ACE inhibitor or ARB at discharge 4_2_1.2
Heart Disease Heart failure - recommended hospital care received Average 2007 93.6 93.6 93.2 2005 3.6% Improved QIO Percentage of hospital patients with heart failure who received recommended hospital care (evaluation of left ventricular ejection fraction and ACE inhibitor or ARB prescription at discharge, if indicated, for left ventricular systolic dysfunction) 4_3_1.2
Heart Disease Congestive heart failure deaths in hospital Average 2006 32.3 32.3 33.1 2000 -7.6% Improved HCUP Deaths per 1,000 adult hospital admissions with congestive heart failure as principal diagnosis (excluding obstetric admissions and transfers to another hospital) 4_3_5.3
Heart Disease Abdominal aortic aneurysm repair deaths in hospital Average 2006 64.8 62.8 65.8 2000 -3.5% Improved HCUP Deaths per 1,000 adult admissions with abdominal aortic aneurysm (AAA) repair (excluding obstetric admissions and transfers to another hospital) 4_4_1.3
Patient Safety Reclosure of postoperative abdominal wound separation per 1,000 discharges Average 2006 2.26 2.5 2.2 2000 0.4% Unchanged HCUP Reclosure of postoperative abdominal wound separation per 1,000 adult abdominopelvic-surgery discharges (excluding immunocompromised patients, stays under 2 days, and obstetric conditions) 12_2_9.4
Patient Safety Iatrogenic pneumothorax per 1,000 discharges Average 2006 .64 0.6 0.7 2000 -3.4% Improved HCUP Iatrogenic pneumothorax per 1,000 adult discharges (excluding obstetrical admissions and patients with chest trauma, thoracic surgery, lung or pleural biopsy, or cardiac surgery) 12_3_5.4
Respiratory Diseases Pneumonia - recommended initial antibiotics in hospital Average 2007 89.4 89.1 89.2 2005 6.7% Improved QIO Percentage of hospital patients with pneumonia who received the initial antibiotic consistent with current recommendations 8_2_4.2
Timeliness Heart attack - PCI in 90 minutes Average 2007 73.7 73.1 73.7 2005 39.1% Improved QIO Percentage of hospital patients with heart attack who received percutaneous coronary intervention (PCI) within 90 minutes of arrival 13_2_3.2


6 State Performance is for the most recent data year compared to All States

7 These all-State averages are calculated consistently across all measures and differ slightly from those in the National Healthcare Quality Report. For more information, select the Methods page.

8 The sign on entries under the column "Average Annual Change" indicates whether the measure has risen or fallen since the baseline year. Because "+" or "-" can represent an improvement or a worsening depending on how the measure is constructed, the column "Direction of Change" helps the user know what the change means.

9 Additional information about data sources/acronyms.

10 Select for other States' rates.

Measures for which California's rate is Worse than the all-State Average

Quality Dimension Short Measure Name State Performance11 Most Recent Data Year State Rate All-State Average12 Regional Average Baseline Year Average Annual Change13 Direction of Change Data Source14 Full NHQR Measure Title NHQR Table Number15
Heart Disease Heart attack deaths in hospital Worse than Average 2006 77.3 73.1 77.7 2000 -4.7% Improved HCUP Deaths per 1,000 adult admissions with acute myocardial infarction (AMI) as principal diagnosis (excluding transfers to another hospital) 4_2_2.3
Heart Disease Heart failure - evaluation of ejection fraction test in hospital Worse than Average 2007 94.5 94.9 94.0 2005 3.3% Improved QIO Percentage of hospital patients with heart failure who received an evaluation of left ventricular ejection fraction 4_3_2.2
Heart Disease Angioplasty deaths in hospital Worse than Average 2006 12.7 11.6 12.8 2000 -3.6% Improved HCUP Deaths per 1,000 adult admissions ages 40 and over with percutaneous transluminal coronary angioplasties (excluding obstetric admissions and transfers to another hospital) 4_4_3.3
Patient Centeredness Heart failure - complete instructions at discharge Worse than Average 2007 75.3 76.8 73.6 2005 22.7% Improved QIO Percentage of hospital patients with heart failure who were given complete written discharge instructions 14_4_3.2
Patient Safety Inpatient surgery - appropriate antibiotic timing Worse than Average 2007 82.7 87.4 83.6 2005 12.4% Improved QIO Percentage of adult surgery patients who received appropriate timing of antibiotics 12_1_2.2
Patient Safety Inpatient surgery - antibiotics within 1 hour Worse than Average 2007 86.4 89.5 86.7 2005 8.9% Improved QIO Percentage of adult surgery patients who received prophylactic antibiotics within 1 hour prior to surgical incision 12_1_3.2
Patient Safety Inpatient surgery - antibiotics stopped within 24 hours Worse than Average 2007 78.8 85.0 80.4 2005 16.8% Improved QIO Percentage of adult surgery patients who had prophylactic antibiotics discontinued within 24 hours after surgery end time 12_1_4.2
Patient Safety Postoperative sepsis per 1,000 elective-surgery discharges Worse than Average 2006 17.1 14.3 15.4 2000 7.5% Worsened HCUP Postoperative sepsis per 1,000 adult elective-surgery discharges with an operating room procedure (excluding patients admitted for infection; patients with cancer or immunocompromised states; obstetric conditions; stays under 4 days; and admissions specifically for sepsis) 12_1_5.3
Patient Safety Selected infections due to medical care per 1,000 discharges Worse than Average 2006 2.49 2.2 2.3 2000 2.6% Worsened HCUP Selected infections due to medical care per 1,000 adult medical and surgical discharges (excluding immunocompromised and cancer patients, stays under 2 days, and admissions specifically for such infections) 12_1_6.4
Patient Safety Deaths per 1,000 admissions in low-mortality DRGs Worse than Average 2006 .48 0.4 0.5 2000 -3.4% Improved HCUP Deaths per 1,000 adult admissions in low-mortality diagnosis-related groups (DRGs) 12_3_9.3
Respiratory Diseases Pneumonia - recommended hospital care received Worse than Average 2007 82.9 85.5 83.0 No Data No Data No Data QIO Percentage of hospital patients with pneumonia who received recommended hospital care 8_2_1.2
Respiratory Diseases Pneumonia - blood cultures before antibiotics in hospital Worse than Average 2007 90.5 91.2 90.6 2005 5.1% Improved QIO Percentage of hospital patients with pneumonia who had blood cultures collected before antibiotics were administered 8_2_2.2
Respiratory Diseases Pneumonia - antibiotics within 6 hours in hospital Worse than Average 2007 81.5 83.2 82.3 No Data No Data No Data QIO Percentage of hospital patients with pneumonia who received the initial antibiotic dose within 6 hours of hospital arrival 8_2_3.2
Respiratory Diseases Pneumonia - flu vaccination screening in hospital Worse than Average 2007 73.8 79.6 72.7 2005 36.0% Improved QIO Percentage of hospital patients age 50 and over with pneumonia discharged during October-February who received influenza screening or vaccination 8_2_5.2
Respiratory Diseases Pneumonia - pneumococcal vaccination screening in hospital Worse than Average 2007 78.3 83.6 78.4 2005 32.1% Improved QIO Percentage of hospital patients age 65 and over with pneumonia who received pneumococcal screening or vaccination 8_2_6.2
Respiratory Diseases Pneumonia deaths in hospital Worse than Average 2006 47.1 45.2 47.2 2000 -7.0% Improved HCUP Deaths per 1,000 adult admissions with pneumonia as principal diagnosis (excluding obstetric admissions and transfers to another hospital) 8_2_7.3


11 State Performance is for the most recent data year compared to All States

12 These all-State averages are calculated consistently across all measures and differ slightly from those in the National Healthcare Quality Report. For more information, select the Methods page.

13 The sign on entries under the column "Average Annual Change" indicates whether the measure has risen or fallen since the baseline year. Because "+" or "-" can represent an improvement or a worsening depending on how the measure is constructed, the column "Direction of Change" helps the user know what the change means.

14 Additional information about data sources/acronyms.

15 Select for other States' rates.