|
|
|
National Data Source
|
National Health Interview Survey
(NHIS), CDC, NCHS.
|
|
State Data Source
|
Behavioral Risk Factor
Surveillance System (BRFSS), CDC, NCCDPHP.
|
|
Healthy People 2000 Objective
|
Adapted from 21.4 (Clinical
Preventive Services).
|
|
Leading Health Indicator
|
Access to Health Care.
|
|
Measure
|
Percent (age adjusted—see
Comments).
|
|
Baseline
|
83 (1997).
|
|
Numerator
|
Number persons under age 65 years
who report coverage by any type of public or private health insurance.
|
|
Denominator
|
Number of persons under age 65
years.
|
|
Population Targeted
|
U.S. civilian,
noninstitutionalized population.
|
|
Questions Used To Obtain the
National Data
|
For questions from the 1997
National Health Interview Survey, Family core, Section IV, Health Insurance,
see:
ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Survey_Questionnaires/
NHIS/1997/qfamilyx.pdf.
|
|
Expected Periodicity
|
Annual.
|
|
Comments
|
Health care coverage includes any type of health insurance or health
care plan, including those obtained by employment, direct purchase, and Government
programs, including Medicare, Medi-Gap, military healthcare/VA, Medicaid,
CHAMPUS/TRICARE/CHAMP-VA, Indian Health Service, State-sponsored health
plans, or other public hospital or physician programs.
|
|
More information on the definition
of health insurance coverage is provided by Health, United States, 2000.1
|
|
Data are age adjusted to the 2000
standard population. Age-adjusted percents are weighted sums of age-specific
percents. For a discussion on age adjustment, see Part A, section 5.
|
|
This measure is a modification of
its comparable Healthy People 2000 objective 21.4, which proposed to improve
the financing and delivery of clinical preventive services. Healthy People
2000 objective 21.4 was tracked by a proxy measure: the proportion of persons
with no health care coverage.2 This objective tracks the
converse measure, the proportion of persons with health care coverage and
does not specifically address delivery of clinical preventive services (see
objective 1-2). Also, this objective is age adjusted; the Healthy People 2000
objective was not.
|
|
This objective is one of the
measures used to track the Access to Health Care Leading Health Indicator.
See Appendix H for a complete listing.
|
|
See Part C for a description of
NHIS and BRFSS and Appendix A for focus area contact information.
|
|
|
|
Comments
|
An operational definition could
not be specified at the time of publication.
|
|
The proposed data source is the
Medical Expenditure Panel Survey (MEPS), AHRQ (formerly AHCPR). The 1996 MEPS
data are currently being analyzed and may provide baseline data on percent of
persons with coverage for selected preventive services (well-child visits,
immunizations, mammograms, cervical cancer screening, and adult physicals).
|
|
The numerator will be the number
of persons who have coverage for clinical preventive services as part of
their health insurance. The denominator will be the number of insured
persons.
|
|
These data are based on an
abstract of the respondents’ insurance policies, rather than household reports.
|
|
This objective is a modification
of Healthy People 2000 objective 21.4, which proposed to improve the
financing and delivery of clinical preventive services (see Comments provided
with objective 1-1 for more information).
|
|
Data will be collected periodically, with as much as a 3-year lag
time in reporting these data.
|
|
Data that are collected periodically
from policy booklets obtained from MEPS household respondents could be
modified to collect information on a broader set of preventive services.
Recommended services to track include childhood and adult immunizations;
recommended cancer screening (breast, cervix, and colon); smoking cessation
counseling; and contraceptive services.
|
|
See Part C for a description of
MEPS and Appendix A for focus area contact information.
|
|
1-3a. (Developmental)
Physical activity or exercise (adults aged 18 years and older).
|
|
Comments
|
An operational definition could
not be specified at time of publication.
|
|
The proposed national data source
is the National Health Interview Survey (NHIS), CDC, NCHS.
|
|
The proposed State data source is
the Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.
|
|
This objective is a modification
of Healthy People 2000 objective 1.12, which tracked the proportion of
clinicians who counseled 81 to 100 percent of their patients about physical
activity and was tracked using the Primary Care Providers Surveys, OPHS,
ODPHP, and the Prevention in Primary Care Study, American College of
Preventive Medicine. This measure will track adults aged 18 years and older
with a physician visit in the past year and is scheduled to be tracked using
NHIS, CDC, NCHS.
|
|
The proposed questions to be used
to obtain the data are scheduled for inclusion in the 2001 NHIS.
|
|
See Part C for a description of
NHIS and Appendix A for focus area contact information.
|
|
1-3b. (Developmental)
Diet and nutrition (adults aged 18 years and older).
|
|
Comments
|
An operational definition could
not be specified at time of publication.
|
|
The proposed national data source
is the National Health Interview Survey (NHIS), CDC, NCHS.
|
|
The proposed State data source is
the Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.
|
|
This objective is a modification
of Healthy People 2000 objective 2.21, which tracked the proportion of
clinicians who counseled 81 to 100 percent of their patients about nutrition
and diet; it was tracked using the Primary Care Providers Surveys, OPHS,
ODPHP and the Prevention in Primary Care Study, American College of Preventive
Medicine. This measure will track adults aged 18 years and older with a
physician visit in the past year, who received counseling on diet and
nutrition; the measure is scheduled to be tracked using the National Health
Interview Survey, CDC, NCHS.
|
|
The proposed questions to be used
to obtain the data are scheduled for inclusion in the 2001 NHIS.
|
|
See Part C for a description of
NHIS and Appendix A for focus area contact information.
|
1-3c. (Developmental)
Smoking cessation (adult smokers aged 18 years and older).
|
|
Comments
|
An operational definition could
not be specified at time of publication.
|
|
The proposed national data source
is the National Health Interview Survey (NHIS), CDC, NCHS.
|
|
The proposed State data source is
the Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.
|
|
This objective is a modification
of Healthy People 2000 objective 3.16, which tracked the proportion of
clinicians who counseled 81 to 100 percent of their patients about smoking
cessation, and was tracked using the Primary Care Providers Surveys, OPHS,
ODPHP and the Prevention in Primary Care Study, American College of Preventive
Medicine. This measure will track adults aged 18 years and older with a
physician visit in the past year who are current smokers or who have quit smoking
in the past 12 months; the measure is scheduled to be tracked using the National
Health Interview Survey, CDC, NCHS.
|
|
The proposed questions to be used
to obtain the data are scheduled for inclusion in the 2001 NHIS.
|
|
See Part C for a description of
NHIS and Appendix A for focus area contact information.
|
|
1-3d. (Developmental)
Reduced alcohol consumption (adults aged 18 years and older with excessive
alcohol consumption).
|
|
Comments
|
An operational definition could
not be specified at time of publication.
|
|
The proposed national data source
is the National Health Interview Survey (NHIS), CDC, NCHS.
|
|
The proposed State data source is
the Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.
|
|
This objective is a modification
of Healthy People 2000 objective 4.19, which tracked the proportion of
clinicians who counseled 81 to 100 percent of their patients about drug and
alcohol use; it was tracked using the Primary Care Providers Surveys, OPHS,
ODPHP and the Prevention in Primary Care Study, American College of
Preventive Medicine. This measure will track adults aged 18 years and older
with a physician visit in the past year who have reported excessive alcohol
consumption; the measure is scheduled to be tracked using the National Health
Interview Survey, CDC, NCHS.
|
|
The proposed questions to be used
to obtain the data are scheduled for inclusion in the 2001 NHIS.
|
|
See Part C for a description of
NHIS and Appendix A for focus area contact information.
|
|
v v v
1-3e. (Developmental)
Childhood injury prevention: vehicle
restraints and bicycle helmets (children aged 17 years and under).
|
|
Comments
|
An operational definition could
not be specified at time of publication.
|
|
The proposed national data source
is the National Health Interview Survey (NHIS), CDC, NCHS.
|
|
The proposed State data source is
the Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.
|
|
This objective is a modification
of Healthy People 2000 objective 9.21, which tracked the proportion of
clinicians who counseled 81 to 100 percent of their patients about injury
prevention; the objective was tracked using the Primary Care Providers
Surveys, OPHS, ODPHP and the Prevention in Primary Care Study, American
College of Preventive Medicine. This measure will track children aged 17
years and under who are reported to have had a physician visit in the past
year and received counseling on the use of vehicle restraints and bicycle
helmets, using the National Health Interview Survey, CDC, NCHS.
|
|
The proposed questions to be used
to obtain the data are scheduled for inclusion in the 2001 NHIS.
|
|
See Part C for a description of
NHIS and Appendix A for focus area contact information.
|
|
1-3f. Unintended
pregnancy (females aged 15 to 44 years).
|
|
National Data Source
|
National Survey on Family Growth
(NSFG), CDC, NCHS.
|
|
State Data Source
|
Not identified.
|
|
Healthy People 2000 Objective
|
Adapted from 14.12 (Maternal and
Infant Health) (also 5.10).
|
|
Measure
|
Percent.
|
|
Baseline
|
19 (1995).
|
|
Numerator
|
Number of women aged 15 to 44 years
with a physician visit in the past 12 months who received counseling on
either birth control or getting sterilized.
|
|
Denominator
|
Number of women aged 15 to 44
years with a physician visit in the past 12 months.
|
|
Population Targeted
|
U.S. civilian, noninstitutionalized
population.
|
|
Questions Used To Obtain the
National Data
|
From the 1995 National Survey on
Family Growth:
|
|
Ø
In the past 12 months, that is since (month/year),
have you received any of the following birth control services from a doctor
or other health care provider?
Counseling
about birth control or a prescription for a method?
Counseling about getting sterilized?
|
|
Expected Periodicity
|
Periodic.
|
|
Comments
|
Women were considered to receive
counseling if they responded “yes” to either receiving counseling about birth
control or getting sterilized.
This objective is a modification
of Healthy People 2000 objective 14.12, which tracked the proportion of clinicians
who counseled 81 to 100 percent of their patients about family planning; it
was tracked using the Primary Care Providers Surveys, OPHS, ODPHP and the
Prevention in Primary Care Study, American College of Preventive Medicine.
|
|
See Part C for a description of
NSFG and Appendix A for focus area contact information.
|
|
1-3g. (Developmental)
Prevention of sexually transmitted diseases (males aged 15 to 49 years,
females aged 15 to 44 years).
|
|
Comments
|
An operational definition could
not be specified at time of publication.
|
|
The proposed national data source
is the National Survey on Family Growth (NSFG), CDC, NCHS.
|
|
This objective is a modification
of Healthy People 2000 objective 18.9 (also 19.14), which tracked the
proportion of clinicians who counseled 81 to 100 percent of their patients
about prevention of HIV and other sexually transmitted diseases; the
objective was tracked using the Primary Care Providers Surveys, OPHS, ODPHP
and the Prevention in Primary Care Study, American College of Preventive
Medicine.
|
|
The 2001 NSFG will collect data on
STD counseling for men aged 15 to 49 years. While the NSFG does collect data
on family planning services for women aged 15 to 44 years [including the
receipt of birth control services (including condoms)], specific questions on
STD counseling among women currently are not included.
|
|
See Part C for a description of
NSFG and Appendix A for focus area contact information.
|
1-3h. (Developmental)
Management of menopause (females aged 46 to 56 years).
|
|
Comments
|
An operational definition could
not be specified at time of publication.
|
|
The proposed national data source
is the National Health Interview Survey (NHIS), CDC, NCHS. The proposed State
data source is the Behavioral Risk Factor Surveillance System (BRFSS), CDC,
NCCDPHP.
|
|
This measure is a modification of
Healthy People 2000 objective 17.18, which tracked the proportion of perimenopausal
women aged 40 to 60 years who were counseled about estrogen replacement therapy.
This measure will track women aged 46 to 56 years who have had a physician
visit in the past year and report that they have received counseling on
management of menopause.
|
|
The proposed questions to be used
to obtain the data are scheduled for inclusion in the 2001 NHIS.
|
|
See Part C for a description of
NHIS and Appendix A for focus area contact information.
|
1-4a. All
ages.
|
National Data Source
|
National Health Interview Survey
(NHIS), CDC, NCHS.
|
|
State Data Source
|
Not identified.
|
|
Healthy People 2000 Objective
|
Adapted from 21.3 (Clinical
Preventive Services), age adjusted to the 2000 standard population.
|
|
Leading Health Indicator
|
Access to Health Care.
|
|
Measure
|
Percent (age adjusted—see
Comments).
|
|
Baseline
|
87 (1998).
|
|
Numerator
|
Number of persons who report
having a specific source of primary care.
|
|
Denominator
|
Number of persons.
|
|
Population Targeted
|
U.S. civilian,
noninstitutionalized population.
|
Questions Used To Obtain the
National Data
|
From the 1998 National Health
Interview Survey:
|
|
Ø Is
there a place that you usually go when you are sick or need advice about your
health?
|
|
Ø
What kind of place is it: a clinic, doctor’s office,
emergency room, or some other place?
(a)
Hospital emergency room
(b) Urgent care/walk-in clinic
(c) Doctor’s office
(d) Clinic
(e) Health center facility
(f) Hospital outpatient clinic
(g) HMO (Health Maintenance Organization)/
Pre-paid group
(h) Military or other VA healthcare
(i) Some other place
|
|
Expected Periodicity
|
Annual.
|
|
Comments
|
A specific source of primary care
includes responses (b) through (i) listed above. A hospital emergency room
(a) is not included as a specific source of primary care.
|
|
Data are age adjusted to the 2000
standard population. Age-adjusted percents are weighted sums of age-specific
percents. For a discussion on age adjustment, see Part A, section 5.
|
|
This measure is modified from its
comparable Healthy People 2000 objective 21.3, which tracked persons aged 18
years and older. This measure tracks persons of all ages and is age adjusted
to the 2000 standard population.
|
|
This objective is one of the
measures used to track the Access to Health Care Leading Health Indicator.
See Appendix H for a complete listing.
|
|
See Part C for a description of
NHIS and Appendix A for focus area contact information.
|
1-4b. Children
and youth aged 17 years and under.
|
National Data Source
|
National Health Interview Survey
(NHIS), CDC, NCHS.
|
|
State Data Source
|
Not identified.
|
|
Healthy People 2000 Objective
|
Adapted from 21.3 (Clinical
Preventive Services).
|
|
Measure
|
Percent (age adjusted—see
Comments).
|
|
Baseline
|
93 (1998).
|
|
Numerator
|
Number of children and youth aged
17 years and under who report having a specific source of primary care.
|
|
Denominator
|
Number of children and youth aged
17 years and under.
|
|
Population Targeted
|
U.S. civilian,
noninstitutionalized population.
|
|
Questions Used To Obtain the
National Data
|
See Questions Used To Obtain the
National Data provided with objective 1-4a.
|
|
Expected Periodicity
|
Annual.
|
|
Comments
|
A specific source of primary care
includes responses (b) through (i) listed in the Questions Used To Obtain the
National Data provided with objective 1-4a, above. A hospital emergency room
(a) is not included as a specific source of primary care.
|
|
Data are age adjusted to the 2000
standard population. Age-adjusted percents are weighted sums of age-specific
percents. For a discussion on age adjustment, see Part A, section 5.
|
|
This measure is modified from its
comparable Healthy People 2000 objective 21.3, which tracked persons aged 18
years and older. This measure tracks children and youth aged 17 years and
under and is age adjusted to the 2000 standard population.
|
|
See Part C for a description of
NHIS and Appendix A for focus area contact information.
|
1-4c. Adults
aged 18 years and older.
|
|
|
National Data Source
|
Medical Expenditure Panel Survey
(MEPS), AHRQ (formerly AHCPR).
|
|
State Data Source
|
Not identified.
|
|
Healthy People 2000 Objective
|
Not applicable.
|
|
Measure
|
Percent.
|
|
Baseline
|
77 (1996).
|
|
Numerator
|
Number of persons who report that
they have a usual primary care provider.
|
|
Denominator
|
Number of persons.
|
|
Population Targeted
|
U.S. civilian,
noninstitutionalized population.
|
|
Questions Used To Obtain the
National Data
|
From the 1996 Medical Expenditure
Panel Survey:
|
|
Ø Is
there a particular doctor’s office, health center, or other place that (Person)
usually goes if (Person) is sick or needs advice about (Person)’s
health?
|
|
Ø
Is (Provider) the (person/place) they would go
for new health problems?
|
|
Ø
Is (Provider) the (person/place) they would go
for preventive health care, such as general checkups, examinations, and
immunizations?
|
|
Ø
Is (Provider) the (person/place) they would go
for referrals to other health professionals when needed?
|
|
Expected Periodicity
|
Annual.
|
|
Comments
|
Persons were determined to have a usual primary care provider if they
reported that they would usually go to the same health professional for all
four of the following situations: if they were sick or needed advice about
their health; if they had new health problems; if they needed preventive care
such as general checkups, examinations, and immunizations; and if they needed
referrals to other health professionals. Persons who reported an emergency
room as their usual source of care were classified as not having a usual
primary care provider.
|
|
See Part C for a description of MEPS and Appendix A for focus area
contact information.
|
|
|
|
National Data Source
|
Medical Expenditure Panel Survey
(MEPS), AHRQ (formerly AHCPR).
|
|
State Data Source
|
Not identified.
|
|
Healthy People 2000 Objective
|
Not applicable.
|
|
Measure
|
Percent.
|
|
Baseline
|
12 (1996).
|
|
Numerator
|
Number of families that report
that at least one family member had difficulty or delay in obtaining health
care or did not receive needed care.
|
|
Denominator
|
Number of families.
|
|
Population Targeted
|
U.S. civilian, noninstitutionalized
population.
|
|
Questions Used To Obtain the
National Data
|
From the 1996 Medical Expenditure
Panel Survey:
|
|
Ø
In the last 12 months, did anyone in the family experience
difficulty in obtaining any type of health care, delay in obtaining care, or
not receive health care they thought they needed due to any of the reasons
listed below?
(1)
Couldn’t afford care
(2) Insurance company wouldn't approve, cover, or pay for care
(3) Pre-existing condition
(4) Insurance required a referral, but couldn't get one
(5) Doctor refused to accept family's insurance plan
(6) Medical care too far away
(7) Can't drive/don't have car/ no public transportation available
(8) Too expensive to get there
(9) Hearing impairment or loss
(10) Different language
(11) Hard to get into building
(12) Hard to get around inside building
(13) No appropriate equipment in office
(14) Couldn't get time off work
(15) Didn't know where to go to get care
(16) Was refused services
(17) Couldn't get child care
(18) Didn't have time or took too long
(19) Other
|
|
Expected Periodicity
|
Annual.
|
|
Comments
|
A family is considered having
difficulty in obtaining care if the head of household responds “yes” to any
of the options (1 through 19) listed in the question above.
|
|
See Part C for a description of
MEPS and Appendix A for focus area contact information.
|
