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North Dakota

Overall Health 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. 24 1560
Average = The State rate on an NHQR measure is not statistically different from the all-State/regional average. 42 2187
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. 18 1930
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. 41 698
Total number of measures for the State (excluding measures that are N/A) 84 5677

Measures for which North Dakota'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
Cancer All cancer deaths Better than Average 2007 165 177.5 179.3 2000 -1.5% Improved NVSS All cancer deaths per 100,000 population 1_4_1.4
Cancer Lung cancer deaths Better than Average 2007 40.9 49.0 51.1 2000 -1.1% Improved NVSS Lung cancer deaths per 100,000 population 1_4_3.4
Diabetes Diabetes eye exams Better than Average 2008 82.4 73.5 77.3 2001 2.7% Improved BRFSS Percentage of adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year 2_1_3.3
End Stage Renal Disease Renal failure and kidney transplant Better than Average 2004 35.6 16.8 25.9 2000 -5.4% Worsened USRDS Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure 3_1_3.3
Functional Status Preservation and Rehabilitation Nursing home long-stay residents - bed/chair bound Better than Average 2008 2.3 3.5 1.6 No Data No Data No Data MDS Percentage of long-stay nursing home residents who spend most of their time in bed or in a chair 10_1_6.3
Functional Status Preservation and Rehabilitation Home health care - improved bathing Better than Average 2008 68.5 64.4 66.1 No Data No Data No Data OASIS Percentage of home health care patients who get better at bathing 10_1_7.3b
Functional Status Preservation and Rehabilitation Home health care - improved drug management Better than Average 2008 52.8 42.7 43.0 No Data No Data No Data OASIS Percentage of home health care patients who get better at taking their medication correctly 10_1_8.3b
Heart Disease Heart attack - ACEI or ARB at discharge Better than Average 2008 98.1 94.1 95.9 2005 3.5% 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
Patient Centeredness Adult patients - poor communication with nurses Better than Average 2009 4.2 5.4 4.0 No Data No Data No Data HCAHPS Percentage of adult hospital patients who sometimes or never had good communication with nurses in the hospital 14_2_2.3
Patient Safety Inpatient surgery - appropriate antibiotic timing Better than Average 2008 93.9 91.9 92.5 2005 6.8% Improved QIO Percentage of adult surgery patients who received appropriate timing of antibiotics 12_1_2.2
Patient Safety Inpatient surgery - antibiotics stopped within 24 hours Better than Average 2008 93.4 90.2 91.6 2005 11.7% Improved QIO Percentage of adult surgery patients who had prophylactic antibiotics discontinued within 24 hours after surgery end time 12_1_4.2
Respiratory Diseases Pneumonia - antibiotics within 6 hours in hospital Better than Average 2008 96.6 93.9 95.2 2007 1.2% Improved QIO Percentage of hospital patients with pneumonia who received the initial antibiotic dose within 6 hours of hospital arrival 8_2_3.2
Supportive and Palliative Care Home health care - home after home health care Better than Average 2008 74.3 68.2 70.0 No Data No Data No Data OASIS Percentage of home health care patients who stay at home after an episode of home health care ended 11_1_10.3
Supportive and Palliative Care Nursing home long-stay residents - received flu vaccine Better than Average 2008 93.8 89.9 92.6 No Data No Data No Data MDS Percentage of long-stay nursing home residents who received influenza vaccination during the flu season 11_1_11.3
Supportive and Palliative Care Nursing home short-stay residents - received flu vaccine Better than Average 2008 89.6 82.7 85.6 No Data No Data No Data MDS Percentage of short-stay nursing home residents who received influenza vaccination during the flu season 11_1_12.3
Supportive and Palliative Care Nursing home long-stay residents - received pneumococcal vaccine Better than Average 2008 94.1 86.3 90.6 No Data No Data No Data MDS Percentage of long-stay nursing home residents who were assessed and received pneumococcal vaccination 11_1_13.3
Supportive and Palliative Care Nursing home short-stay residents - received pneumococcal vaccine Better than Average 2008 90.5 79.7 83.4 No Data No Data No Data MDS Percentage of short-stay nursing home residents who were assessed and received pneumococcal vaccination 11_1_14.3
Supportive and Palliative Care Nursing home long-stay residents - physically restrained Better than Average 2008 1.8 3.4 2.0 No Data No Data No Data MDS Percentage of long-stay nursing home residents who were physically restrained 11_1_17.3
Supportive and Palliative Care Nursing home long-stay residents - high-risk with pressure sores Better than Average 2008 6.9 11.4 8.2 No Data No Data No Data MDS Percentage of high-risk long-stay nursing home residents who have pressure sores 11_1_18.3
Supportive and Palliative Care Nursing home long-stay residents - with urinary tract infections Better than Average 2008 6.6 8.8 8.6 No Data No Data No Data MDS Percentage of long-stay nursing home residents with a urinary tract infection 11_1_2.3
Supportive and Palliative Care Nursing home short-stay residents - with pressure sores Better than Average 2008 16 18.1 12.8 No Data No Data No Data MDS Percentage of short-stay nursing home residents with pressure sores 11_1_20.3
Supportive and Palliative Care Nursing home long-stay residents - low-risk with less control of bowels or bladder Better than Average 2008 45.9 50.2 43.5 No Data No Data No Data MDS Percentage of low-risk long-stay nursing home residents who lose control of their bowels or bladder 11_1_4.3
Supportive and Palliative Care Home health care - improved breathing Better than Average 2008 66.4 60.3 60.2 No Data No Data No Data OASIS Percentage of home health care patients who have less shortness of breath 11_1_7.3b
Supportive and Palliative Care Home health care - needed urgent care Better than Average 2008 18.7 22.1 21.3 No Data No Data No Data OASIS Percentage of home health care patients who need urgent, unplanned medical care 11_1_9.3b


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 North Dakota'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
Cancer Mammograms Average 2008 75.6 76.2 74.9 2000 0.1% Unchanged BRFSS Percentage of women age 40 and over who received a mammogram in the last 2 years 1_1_1.3
Cancer Breast cancer deaths Average 2007 23.1 22.7 22.2 2000 -0.8% Unchanged NVSS Breast cancer deaths per 100,000 female population 1_1_5.4
Cancer Pap tests Average 2008 79.9 79.0 79.0 2000 -0.1% Unchanged BRFSS Percentage of women age 18 and over who received a Pap smear within the last 3 years 1_2_1.3
Cancer Fecal occult blood tests Average 2008 20.2 21.6 20.6 2001 -3.7% Worsened BRFSS Percentage of adults age 50 and over who received a fecal occult blood test in the last 2 years 1_3_3.3
Cancer Colorectal cancer deaths Average 2007 16.3 16.8 17.1 2000 -2.1% Improved NVSS Colorectal cancer deaths per 100,000 population per year 1_3_6.4
Cancer Prostate cancer deaths Average 2007 20.6 23.2 23.3 2000 -6.3% Improved NVSS Prostate cancer deaths per 100,000 male population 1_4_2.4
Care Coordination Heart failure - complete instructions at discharge Average 2008 83.6 82.6 82.0 2005 6.3% Improved QIO Percentage of hospital patients with heart failure who were given complete written discharge instructions 14_4_3.2
Diabetes Diabetes hemoglobin A1c tests Average 2008 91.6 91.8 92.5 2001 -0.2% Unchanged BRFSS Percentage of adults age 40 and over with diagnosed diabetes who received a hemoglobin A1c measurement in the calendar year 2_1_2.3
Diabetes Diabetes foot exams Average 2008 75.9 74.3 76.7 2001 -0.3% Unchanged BRFSS Percentage of adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year 2_1_4.3
Diabetes Diabetes with flu shots Average 2008 52.7 47.0 50.3 2001 -0.9% Unchanged BRFSS Percentage of noninstitutionalized high-risk adults ages 18-64 with diabetes who had an influenza immunization in the past year 2_1_5.3
End Stage Renal Disease Dialysis and on kidney transplant list Average 2006 20.2 15.9 17.9 2000 -3.3% Worsened USRDS Percentage of dialysis patients under age 70 who were registered on a waiting list for transplantation 3_1_2.3
End Stage Renal Disease Mortality ratio for dialysis patients Average 2008 0.9 0.9 0.9 2000 -2.5% Improved UMKECC Ratio of observed deaths to expected deaths among hemodialysis patients 3_1_4.1
End Stage Renal Disease End stage renal disease - hemodialysis with arteriovenous fistula Average 2009 17.9 13.1 13.1 2008 68.9% Improved FFIAF_AVFD Percentage of new end stage renal disease patients who initiated hemodialysis with an arteriovenous fistula 3_1_5.2
Functional Status Preservation and Rehabilitation Home health care - improved mobility Average 2008 43.3 44.3 46.1 No Data No Data No Data OASIS Percentage of home health care patients who get better at walking or moving around 10_1_2.3b
Functional Status Preservation and Rehabilitation Nursing home long-stay residents - with declining mobility Average 2008 15.5 15.5 14.1 No Data No Data No Data MDS Percentage of long-stay nursing home residents whose ability to move about in and around their room declined 10_1_3.3
Heart Disease Heart failure - ACEI/ARB at discharge Average 2008 93.2 92.4 92.5 2005 2.4% 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
Maternal and Child Health Children fully vaccinated Average 2008 74.2 77.7 77.0 2000 -1.0% Worsened NIS Percentage of children ages 19-35 months who received all recommended vaccines (4:3:1:3:3) 6_3_1.3
Maternal and Child Health Children receiving DPT vaccine Average 2008 81 84.8 84.5 2000 -0.7% Unchanged NIS Percentage of children ages 19-35 months who received 4 or more doses of diphtheria-pertussis-tetanus vaccine 6_3_2.3
Maternal and Child Health Children receiving polio vaccine Average 2008 95.1 96.2 94.6 2000 0.5% Unchanged NIS Percentage of children ages 19-35 months who received 3 or more doses of polio vaccine 6_3_3.3
Maternal and Child Health Children receiving MMR vaccine Average 2008 90.6 92.2 92.0 2000 -0.1% Unchanged NIS Percentage of children ages 19-35 months who received 1 dose of measles-mumps-rubella vaccine 6_3_4.3
Maternal and Child Health Children receiving hepititis B vaccine Average 2008 95.5 94.3 94.2 2000 -0.0% Unchanged NIS Percentage of children ages 19-35 months who received 3 or more doses of hepatitis B vaccine 6_3_6.3
Patient Centeredness Always had good communication with providers - adults on Medicare fee-for-service Average 2009 75.2 74.7 74.3 2007 3.1% Improved CAHPS Percentage of adults who had a doctor's office or clinic visit in the last 12 months whose health providers always listened carefully, explained things clearly, respected what they had to say, and spent enough time with them, Medicare fee-for-service 14_1_1.3
Patient Centeredness Adult patients - poor communication with doctors Average 2009 4.9 5.0 4.0 No Data No Data No Data HCAHPS Percentage of adult hospital patients who sometimes or never had good communication with doctors in the hospital 14_2_1.3
Patient Safety Inpatient surgery - antibiotics within 1 hour Average 2008 94.3 93.6 93.1 2005 2.9% Improved QIO Percentage of adult surgery patients who received prophylactic antibiotics within 1 hour prior to surgical incision 12_1_3.2
Respiratory Diseases Flu vaccine in past 12 months - high-risk, age 18-64 Average 2007 38.5 38.4 41.5 2003 4.2% Improved BRFSS Percentage of adults ages 18-64 at high risk (e.g., COPD) who received an influenza vaccination in the last 12 months 8_1_1.3
Respiratory Diseases Flu vaccine - age 65 and over Average 2008 72.6 71.7 74.3 2001 0.5% Unchanged BRFSS Percentage of adults age 65 and over who received an influenza vaccination in the last 12 months 8_1_2.4
Respiratory Diseases Pneumonia vaccine ever - high-risk, age 18-64 Average 2007 28.3 26.3 25.8 2003 1.6% Improved BRFSS Percentage of high-risk people ages 18-64 who ever received a pneumococcal vaccination 8_1_4.3
Respiratory Diseases Pneumonia vaccine ever - age 65 plus Average 2008 67.6 67.6 68.1 2001 0.7% Unchanged BRFSS Percentage of adults age 65 and over who ever received a pneumococcal vaccination 8_1_5.4
Respiratory Diseases Pneumonia - blood cultures before antibiotics in hospital Average 2008 92.4 93.3 94.8 2005 3.3% Improved QIO Percentage of hospital patients with pneumonia who had blood cultures collected before antibiotics were administered 8_2_2.2
Respiratory Diseases Pneumonia - flu vaccination screening in hospital Average 2008 86.2 85.5 86.1 2005 5.2% 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
Supportive and Palliative Care Nursing home long-stay residents - with moderate to severe pain Average 2008 6 6.5 6.9 No Data No Data No Data MDS Percentage of long-stay nursing home residents who have moderate to severe pain 11_1_1.3
Supportive and Palliative Care Home health care - improved pain management when mobile Average 2008 62.9 63.3 61.9 No Data No Data No Data OASIS Percentage of home health care patients who have less pain when moving around 11_1_16.3
Supportive and Palliative Care Nursing home long-stay residents - low-risk with pressure sores Average 2008 2.1 2.0 2.0 No Data No Data No Data MDS Percentage of low-risk long-stay nursing home residents who have pressure sores 11_1_19.3
Supportive and Palliative Care Hospice care - timely referral to hospice Average 2009 88.5 89.4 89.2 2007 -0.4% Unchanged FEHCS Percentage of hospice patient caregivers who perceived patient was referred to hospice at the right time 11_1_23.2
Supportive and Palliative Care Hospice care - appropriate medication for pain management Average 2009 94.7 94.8 95.2 2008 -0.1% Unchanged FEHCS Percentage of hospice patients who received the right amount of medicine for pain management 11_1_24.2
Supportive and Palliative Care Hospice care - patients' wishes followed Average 2009 94.7 94.7 95.1 2008 3.2% Improved FEHCS Percentage of hospice patients who received care consistent with their wishes 11_1_25.2
Supportive and Palliative Care Family caregivers - wanting limited information about death expectations Average 2009 87 85.1 87.3 2007 -0.6% Unchanged FEHCS Percentage of family caregivers who did not want more information about what to expect while the patient was dying 11_1_28.2
Supportive and Palliative Care Hospice patients - help for anxiety and sadness Average 2009 92.1 90.8 92.3 No Data No Data No Data FEHCS Percentage of hospice patients who received the right amount of help for feelings of anxiety or sadness 11_1_29.2
Supportive and Palliative Care Nursing home long-stay residents - with too much weight loss Average 2008 8.1 8.3 7.1 No Data No Data No Data MDS Percentage of long-stay nursing home residents who lose too much weight 11_1_6.3
Timeliness Always got routine appointments - adults on Medicare fee-for-service Average 2009 59.6 61.5 60.8 2007 8.0% Improved CAHPS Percentage of adults who had an appointment for routine health care in the last 12 months who always got appointments for routine care as soon as wanted, Medicare fee-for-service 13_1_1.3
Timeliness Always got appointment for illness/injury/condition - adults on Medicare fee-for-service Average 2009 70.3 69.5 71.3 2007 0.1% Unchanged CAHPS Percentage of adults who needed care right away for an illness, injury, or condition in the last 12 months who always got care as soon as wanted, Medicare fee-for-service 13_1_3.3
Timeliness Heart attack - PCI in 90 minutes Average 2008 87.4 82.4 87.7 2005 11.4% 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 North Dakota'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
Cancer Colonoscopy or sigmoidoscopy Worse than Average 2008 58.2 64.2 62.6 2001 2.3% Improved BRFSS Percentage of adults age 50 and over who ever received a colonoscopy or sigmoidoscopy 1_3_2.3
End Stage Renal Disease Adequate dialysis Worse than Average 2008 93.3 96.2 95.0 2000 0.9% Unchanged UMKECC Percentage of adult hemodialysis patients with adequate dialysis 3_1_1.2
Functional Status Preservation and Rehabilitation Home health care - improved ability to get in and out of bed Worse than Average 2008 46.1 53.2 54.9 No Data No Data No Data OASIS Percentage of home health care patients who get better at getting in and out of bed 10_1_4.3b
Functional Status Preservation and Rehabilitation Nursing home long-stay residents - with increased need for help Worse than Average 2008 16.9 15.4 14.9 No Data No Data No Data MDS Percentage of long-stay nursing home residents whose need for help with daily activities has increased 10_1_5.3
Heart Disease Blood cholesterol testing Worse than Average 2007 71.8 74.4 72.4 2001 0.2% Unchanged BRFSS Percentage of adults who had their blood cholesterol checked within the preceding 5 years 4_1_3.4
Heart Disease Heart failure - recommended hospital care received Worse than Average 2008 91.4 95.3 94.0 2005 1.6% Improved QIO Percentage of hospital patients with heart failure who received recommended hospital care 4_3_1.2
Heart Disease Heart failure - evaluation of ejection fraction test in hospital Worse than Average 2008 90.9 96.5 94.1 2005 1.4% Improved QIO Percentage of hospital patients with heart failure who received an evaluation of left ventricular ejection fraction 4_3_2.2
Maternal and Child Health Children receiving Hib vaccine Worse than Average 2008 85.2 91.7 89.1 2000 -1.5% Worsened NIS Percentage of children ages 19-35 months who received 3 or more doses of Haemophilus influenzae type B (Hib) vaccine 6_3_5.3
Maternal and Child Health Children receiving varicella vaccine Worse than Average 2008 85 90.7 88.8 2000 4.7% Improved NIS Percentage of children ages 19-35 months who received 1 or more dose of varicella vaccine 6_3_7.3
Mental Health and Substance Abuse Suicide deaths Worse than Average 2007 14.4 10.7 12.0 2000 4.8% Worsened NVSS Suicide deaths per 100,000 population 7_1_7.4
Respiratory Diseases Pneumonia - recommended hospital care received Worse than Average 2008 89.7 90.4 91.1 2007 1.4% Improved QIO Percentage of hospital patients with pneumonia who received recommended hospital care 8_2_1.2
Respiratory Diseases Pneumonia - recommended initial antibiotics in hospital Worse than Average 2008 86.8 89.5 88.9 2005 2.7% Improved QIO Percentage of hospital patients with pneumonia who received the initial antibiotic consistent with current recommendations 8_2_4.2
Respiratory Diseases Pneumonia - pneumococcal vaccination screening in hospital Worse than Average 2008 86.5 88.5 88.8 2005 4.8% Improved QIO Percentage of hospital patients age 65 and over with pneumonia who received pneumococcal screening or vaccination 8_2_6.2
Supportive and Palliative Care Nursing home short-stay residents - with moderate to severe pain Worse than Average 2008 23.4 20.3 22.5 No Data No Data No Data MDS Percentage of short-stay nursing home residents who had moderate to severe pain 11_1_15.3
Supportive and Palliative Care Nursing home short-stay residents - with delirium Worse than Average 2008 5.1 2.7 3.8 No Data No Data No Data MDS Percentage of short-stay nursing home residents with delirium 11_1_21.3
Supportive and Palliative Care Nursing home long-stay residents - more depressed or anxious Worse than Average 2008 18.9 13.7 16.9 No Data No Data No Data MDS Percentage of long-stay nursing home residents who are more depressed or anxious 11_1_3.3
Supportive and Palliative Care Nursing home long-stay residents - low-risk with urinary catheter left in Worse than Average 2008 7.54 6.2 6.3 No Data No Data No Data MDS Percentage of low-risk long-stay nursing home residents with a catheter inserted and left in their bladder 11_1_5.3
Supportive and Palliative Care Home health care - less urinary incontinence Worse than Average 2008 43.5 47.6 44.6 No Data No Data No Data OASIS Percentage of home health care patients who have less urinary incontinence 11_1_8.3b


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.