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Agency for Healthcare Quality and Research (AHRQ) Data
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Executive Summary
The AHRQ database is comprised of administrative data voluntarily reported since the 1990s. Though initially constructed to track health care trends, recent efforts have been made to use the database to examine clinical outcomes. AHRQ advises using this information as a screening tool to identify potential issues that may require deeper investigation, and strongly advises against using this information to draw clinical conclusions.
After review of the 55 AHRQ indicators in quality and safety, the Data Committee of the Iowa Healthcare Collaborative selected 11 measures to present in this report. The primary selection criteria was the existence of an adequate number of hospitals with significant number of cases (N>30) to minimize variability due to small numbers in reporting. The Committee also considered variability in coding procedure that may confound reporting.
The 2005 report presents aggregated state performance and compares it to several categories. Iowa performance met or exceeded the national average in 9 of these 11 categories reported. The Data Committee anticipates reporting hospital-specific information in 2006 when the case number threshold has been met.
Introduction
AHRQ is the health services research arm of the U.S. Department of Health and Human Services (HHS). AHRQ’s mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.
In the early 1990s, several organizations requested assistance from AHRQ to provide a set of quality measures that used the information within routine hospital administrative data. AHRQ responded by creating the Healthcare Cost and Utilization Project (HCUP)—a federal, state, and private sector collaborative effort—to build health care databases from U.S. hospitals’ administrative data and develop the original 33 HCUP Quality Indicators (QIs). These examine in-hospital mortality, complications of medical procedures, inappropriate uses of services, and ambulatory care-sensitive conditions. As nationwide interest grew in the use of the QIs as effective quality measurement tools, AHRQ funded a project with the University of California San Francisco and Stanford University to adapt, expand, and refine the 33 original Quality Indicators. There are now 71 state-of-the-art QIs organized into Patient Safety Indicators, Inpatient Quality Indicators, and Prevention Quality Indicators.
As a public reporting tool, the QI measures are being used to compare variations in quality between geographical regions and/or providers, to monitor the incidence of new events, and to detect trends over time. Overall, the QIs allow health care researchers, stakeholders, providers, and the public to assess health care issues.
Although the AHRQ QIs are easy to use and inexpensive quality measures, AHRQ strongly cautions users regarding their use and interpretation. Due to the inherent limitations in using administrative data, AHRQ suggests that QIs be used as simple screening tools to identify potential issues that may require deeper investigation and not as definitive measures of the quality of care.
The Iowa Healthcare Collaborative has used the AHRQ database to examine care provided to Iowans. The Data Committee has recommended that the following 11 QI measures be presented as state aggregated information to the public.
Special thanks to the University of Iowa College of Public Health for their assistance in reviewing this data.
Description of data
- Hospital submitted administrative data received by AHRQ
- All Payors, calendar year 2002 discharges
Data Display descriptors
- Iowa Rate- Aggregate State Rate
- Midwest States Rate
- U.S. Rate
- Highest U.S. State Rate
- Lowest U.S. State Rate
Data
- PTCA Mortality Rate Comparisons – (IQI 30)
- CABG Mortality Rate Comparisons – (IQI 12)
- Birth Trauma – Injury to neonate Rate Comparisons* - (PSI 17)
- Carotid Endarterectomy Angioplasty Mortality Rate* - (IQI 31)
- Decubitus Ulcer Rate Comparisons* - (PSI 3)
- Low Mortality DRG Mortality Rate Comparison* - (PSI 2)
- Postoperative Hip Fracture Rate Comparisons* - (PSI 8)
- Foreign Body left in during Procedure Rate Comparisons* - (PSI 5)
- Postoperative Wound Dehiscence Rate Comparisons* - (PSI 14)
- Postoperative Pulmonary Embolism/Deep Vein Thrombosis Rate Comparison* - (PSI 12)
- Accidental Puncture of Laceration Rate Comparisons* - (PSI 15)
* Iowa performance meets or exceeds national performance
Back to top
Main section of the 2005 Iowa Report .
The Hospital Quality Initiative is a voluntary reporting effort by hospitals on a selected group of clinical measures.
The AHRQ database is comprised of administrative data voluntarily reported since the 1990s.
The National Quality Forum (NQF) identified the set of 30 safe practices in May of 2004.
Through conferences, meetings, and site visits, providers are sharing best practice and are working to reduce preventable deaths in Iowa.
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