| Prevalence/Incidence (Source) |
Health Care Cost/Utilization (Source) |
| 1. Timeliness of Prenatal Care |
- Number of discharges for liveborns with Medicaid as payer (HCUPNet, 2011)
- Number of discharges for liveborns with Medicaid as payer by race/ethnicity (MAX)
- Number of discharges for liveborns for all payers (HCUPNet, 2011)
- Medicaid percentage of all payer discharges for liveborns (HCUPNet, 2011)
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- Aggregate costs and mean costs per discharge for liveborns with Medicaid as payer (HCUPNet, 2011)
- Aggregate costs and mean costs per discharge for liveborns with Medicaid as payer by race/ethnicity (MAX)
- Aggregate costs and mean cost per discharge for liveborns all payers (HCUPNet, 2011)
- Medicaid percentage of all payer costs for liveborns (HCUPNet, 2011)
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| 2. Frequency of Ongoing Prenatal Care |
- Number of discharges for liveborns with Medicaid as payer (HCUPNet, 2011)
- Number of discharges for liveborns with Medicaid as payer by race/ethnicity (MAX)
- Number of discharges for liveborns for all payers (HCUPNet, 2011)
- Medicaid percentage of all payer discharges for liveborns (HCUPNet, 2011)
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- Aggregate costs and mean costs per discharge for liveborns with Medicaid as payer (HCUPNet, 2011)
- Aggregate costs and mean costs per discharge for liveborns with Medicaid as payer by race/ethnicity (MAX)
- Aggregate costs and mean cost per discharge for liveborns all payers (HCUPNet, 2011)
- Medicaid percentage of all payer costs for liveborns (HCUPNet, 2011)
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| 3. Live Births Weighing Less Than 2,500 Grams |
- Number of discharges for premature birth and low birth weight with Medicaid as payer (HCUPNet, 2011)
- Number of discharges for premature birth and low birth weight with Medicaid as payer by race/ethnicity (MAX)
- Number of discharges for premature birth and low birth weight for all payers (HCUPNet, 2011)
- Medicaid % of all payer discharges for premature birth and low birth weight (HCUPNet, 2011)
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- Aggregate costs and mean costs per discharge for hospitalizations for premature birth and low birth weight with Medicaid as payer (HCUPNet, 2011)
- Aggregate costs and mean costs per discharge for hospitalizations for premature birth and low birth weight with Medicaid as payer by race/ethnicity (MAX)
- Aggregate costs and mean cost per discharge for premature birth and low birthweight all payers (HCUPNet, 2011)
- Medicaid percentage of all payer costs for premature birth and low birth weight (HCUPNet, 2011)
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| 4. Cesarean Rate for Nulliparous Singleton Vertex |
- Number of discharges for cesarean deliveries with Medicaid as payer (HCUPNet, 2011)
- Number of discharges for cesarean deliveries with Medicaid as payer by race/ethnicity (MAX)
- Number of discharges for cesarean deliveries all payers (HCUPNet, 2011)
- Medicaid percentage of all payer discharges for cesarean deliveries (HCUPNet, 2011)
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- Aggregate costs and mean costs per discharge for hospitalizations for cesarean deliveries with Medicaid as payer (HCUPNet, 2011)
- Aggregate costs and mean costs per discharge for hospitalizations for cesarean deliveries with Medicaid as payer by race/ethnicity (MAX)
- Aggregate costs and mean cost per discharge for cesarean deliveries all payers (HCUPNet, 2011)
- Medicaid % of all payer costs for cesarean deliveries (HCUPNet, 2011)
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| 5. Childhood Immunization Status |
- Number of Medicaid/CHIP-enrollees who turn 2 during the year (MAX)
- Number of Medicaid/CHIP-enrollees who turn 2 during the year by race/ethnicity (MAX)
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| 6. Adolescent Immunization Status |
- Number of Medicaid/CHIP-enrollees who turn 13 during the year (MAX)
- Number of Medicaid/CHIP-enrollees who turn 13 during the year by race/ethnicity (MAX)
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| 7. Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Body Mass Index Assessment for Children/Adolescents |
- Number and percentage of children age 10-17 with public insurance who are obese (NSCH)
- Number of Medicaid/CHIP enrollees age 3-17 (MAX)
- Number of Medicaid/CHIP enrollees age 3-17 by race/ethnicity (MAX)
- Number and percentage of children age 10-17 who are obese (NSCH)
- Number and percentage of children age 10-17 who are obese by race/ethnicity (NSCH)
- Number and percentage of children age 10-17 who are obese by income level (NSCH)
- Number and percentage of children age 10-17 who are obese by special health care needs status (NSCH)
- Medicaid as percentage of the total population (NSCH)
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| 8. Developmental Screening In the First Three Years of Life |
- Number and percentage of children age 2-17 with public insurance who have developmental delay (NSCH)
- Number of Medicaid/CHIP enrollees ages 0-3 (MAX)
- Number and percentage of children age 2-17 with developmental delay (NSCH)
- Number and percentage of children age 2-17 with developmental delay by race/ethnicity (NSCH)
- Number and percentage of children age 2-17 with developmental delay by income level (NSCH)
- Number and percentage of children age 2-17 with developmental delay by special health care needs status (NSCH)
- Medicaid as % of total population (NSCH)
- Existing Literature
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| 9. Chlamydia Screening—sexually active females ages 16-20 |
- Number of female Medicaid/CHIP enrollees age 16-20 who are sexually active (MAX)
- Existing Literature
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- Total Medicaid expenditures for claims with diagnosis code for pelvic inflammatory disease for females age 16-20 (MAX)
- Total Medicaid expenditures for claims with diagnosis code for pelvic inflammatory disease for females age 16-20 by race/ethnicity (NSCH)
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| 10. Well-Child Visits in the First 15 Months of Life |
- Number of Medicaid/CHIP enrollees age 0—15 months (MAX)
- Number of Medicaid/CHIP enrollees age 0—15 months by race/ethnicity (MAX)
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- Number of well-child visits for children age 0-15 months (MAX)
- Number of well-child visits for children age 0-15 months by race/ethnicity (MAX)
- Total Medicaid expenditures for well-child visits for children age 0-15 months (MAX)
- Total Medicaid expenditures for well-child visits for children age 0-15 month by race/ethnicity (MAX)
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| 11. Well-Child Visits in the 3rd, 4th, 5th, and 6th Years of Life |
- Number of Medicaid/CHIP enrollees age 3—6 years (MAX)
- Number of Medicaid/CHIP enrollees age 3—6 years by race/ethnicity (MAX)
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- Number of well-child visits for children age 3-6 (MAX)
- Number of well-child visits for children age 3-6 by race/ethnicity (MAX)
- Total Medicaid expenditures for well-child visits for children age 3—6 (MAX)
- Total Medicaid expenditures for well-child visits for children age 3—6 by race/ethnicity (MAX)
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| 12. Adolescent Well-Care Visit |
- Number of Medicaid/CHIP-enrollees age 12-17 years (MAX)
- Number of Medicaid/CHIP-enrollees age 12-17 years by race/ethnicity (MAX)
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- Number of well-child visits for children age 12-17 (MAX)
- Number of well-child visits for children age 12-17 by race/ethnicity (MAX)
- Total Medicaid expenditures for well-child visits for children age 12-17 (MAX)
- Total Medicaid expenditures for well-child visits for children age 12-17 by race/ethnicity (MAX)
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| 13. Child and Adolescent Access to Primary Care Practitioners |
- Number of Medicaid/CHIP-enrollees (MAX)
- Number of Medicaid/CHIP-enrollees by age (12-24 months, 25 months6 years, 7-11 years, 12-19 years) (MAX)
- Number of Medicaid/CHIP-enrollees by race/ethnicity (MAX)
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| 14. Appropriate Testing for Children with Pharyngitis |
- Percentage of children enrolled in Medicaid who sought treatment for sore throat (not pharyngitis specific), 2002-2004 (MEPS)
- Percentage of total children who sought treatment for sore throat (not pharyngitis specific) (MEPS)
- Percentage of total children who sought treatment for sore throat (not pharyngitis specific) by race/ethnicity (MEPS)
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- Medicaid expenditures for antibiotic prescriptions to treat pharyngitis for children age 2-18 (MAX)
- Medicaid expenditures for antibiotic prescriptions to treat pharyngitis for children age 2-18 by race/ethnicity (MAX)
- Medicaid expenditures for antibiotic prescriptions to treat pharyngitis for children age 2-18 as a percentage of total Medicaid expenditures for prescriptions for children age 2-18 (MAX)
- Medicaid expenditures for antibiotic prescriptions to treat pharyngitis for children age 2-18 as a percentage of total Medicaid expenditures for prescriptions for children age 2-18 by race/ethnicity (MAX)
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| 15. Ambulatory Care—Emergency Department (ED) Visits |
- Number of Medicaid/CHIP enrollees age 0-19 with ED visits (MAX)
- Number of Medicaid/CHIP enrollees age 0-19 with ED visits by age (<1, 1-9, 10-19) (MAX)
- Number of Medicaid/CHIP enrollees age 0-19 with ED visits by race/ethnicity (MAX)
- Number of ED visits among children age 0-19 (MAX)
- Number of ED visits among children by age 0-19 age (<1, 1-9, 10-19) (MAX)
- Number of ED visits among children age 0-19 by race/ethnicity (MAX)
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- Total expenditures for ED visits for children age 0-19 (MAX)
- Total expenditures for ED visits for children age 0-19 by age (<1, 1-9, 1019) (MAX)
- Total expenditures for ED visits for children age 0-19 by race/ethnicity (MAX)
- Mean expenditures per ED visit (MAX)
- Mean expenditures per ED visit by age (<1, 1-9, 10-19) (MAX)
- Mean expenditures per ED visit by race/ethnicity (MAX)
- Mean expenditures for ED visits per child (MAX)
- Mean expenditures for ED visits per child by age (<1, 1-9, 10-19) (MAX)
- Mean expenditures for ED visits per child by race/ethnicity (MAX)
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| 16. Pediatric Central Line–Associated Blood Stream Infections—Neonatal Intensive Care Unit and Pediatric Intensive Care Unit |
- Number of admissions with NICU or PICU hospital stays (MAX)
- Number of admissions with NICU or PICU hospital stays by race/ethnicity (MAX)
- Admissions with NICU or PICU stay as percentage of total hospital admissions for children (MAX)
- Admissions with NICU or PICU stay as percentage of total hospital admissions for children by race/ethnicity (MAX)
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- Total and mean Medicaid expenditures per discharge for admissions that include NICU or PICU stays (MAX)
- Total and mean Medicaid expenditures per discharge for admissions that include NICU or PICU stays by race/ethnicity (MAX)
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| 17. Annual Percentage of Asthma Patients 2 Through 20 Years Old with One or More Asthma-Related Emergency Room Visits |
- Number and percentage of children age 0-17 with public insurance who have current asthma (NSCH)
- Number and percentage of total children age 2-17 with current asthma (NSCH)
- Number and percentage of total children age 2-17 with current asthma by race/ethnicity (NSCH)
- Number and percentage of total children age 2-17 with current asthma by income level (NSCH)
- Number and percentage of total children age 2-17 with current asthma by special health care needs status (NSCH)
- Medicaid as a percentage of the total population (NSCH)
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- Number of child ED visits for asthma among children age 2-20 (MAX)
- Number of child ED visits for asthma among children age 2-20 by race ethnicity (MAX)
- Mean child Medicaid expenditures per ED visit for asthma among children age 2-20 (MAX)
- Mean child Medicaid expenditures per ED visit for asthma among children age 2-20 by race/ethnicity (MAX)
- Total Medicaid expenditures for ED visits with asthma diagnosis among children age 2-20 (MAX)
- Total Medicaid expenditures for ED visits with asthma diagnosis among children age 2-20 by race/ethnicity (MAX)
- Medicaid expenditures for ED visits for asthma for children age 2-20 as a percentage of total Medicaid expenditures for ED visits for children age 2-20 (MAX)
- Asthma-related ED visits for children age 2-20 as a percentage of total ED visits for children age 2-20 (MAX)
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| 18. Follow-Up Care for Children Prescribed Attention Deficit Hyperactivity Disorder (ADHD) Medication |
- Number and percentage of children age 2-17 with public insurance with ADD or ADHD (NSCH)
- Number and percentage of children age 2-17 with public insurance with ADD/ADHD currently taking medication for this condition (NSCH)
- Number and percentage of children age 2-17 with ADD or ADHD (NSCH)
- Number and percentage of children age 2-17 with ADD or ADHD by race/ethnicity (NSCH)
- Number and percentage of children age 2-17 with ADD or ADHD by income level (NSCH)
- Number and percentage of children age 2-17 with ADD or ADHD by special health care needs status (NSCH)
- Medicaid as a percentage of total population (NSCH)
- Number and percentage of children age 2-17 with ADD/ADHD currently taking medication for this condition (NSCH)
- Number and percentage of children age 2-17 with ADD/ADHD currently taking medication for this condition by race/ethnicity (NSCH)
- Number and percentage of children age 2-17 with ADD/ADHD currently taking medication for this condition by income level (NSCH)
- Number and percentage of children age 2-17 with ADD/ADHD currently taking medication for this condition by special health care needs status (NSCH)
- Medicaid as % of total population (NSCH)
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- Total expenditures for prescriptions for ADHD medications among children age 6-12 (MAX)
- Total expenditures for prescriptions for ADHD medications among children age 6-12 by race/ethnicity (MAX)
- Expenditures for prescriptions for ADHD as percentage of total Medicaid expenditures for children age 6-12 (MAX)
- Expenditures for prescriptions for ADHD as percentage of total Medicaid expenditures for children age 6-12 by race/ethnicity (MAX)
- Expenditures for prescriptions for ADHD as percentage of Medicaid expenditures for prescriptions for children as 6-12 (MAX)
- Expenditures for prescriptions for ADHD as percentage of Medicaid expenditures for prescriptions for children as 6-12 by race/ethnicity (MAX)
- Expenditures for prescriptions for ADHD as percentage of total Medicaid expenditures for prescriptions (total population <65) (MAX)
- Expenditures for prescriptions for ADHD as percentage of total Medicaid expenditures for prescriptions (total population <65) by race ethnicity (MAX)
- Medicaid as percentage of total (all-payer) expenditures for treatment of ADHD (MEPS)
- Medicaid as percentage of total (all-payer) ambulatory ADHD visit expenditures (MEPS)
- Medicaid as % of total (all-payer) expenditures for prescription medications for ADHD (MEPS)
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| 19. Annual Pediatric Hemoglobin A1C Testing |
- Number and percentage of children in public insurance age 0-17 with current diabetes (NSCH)
- Number and percentage of children age 0-17 with current diabetes (NSCH)
- Number and percentage of children age 0-17 with current diabetes by race/ethnicity (NSCH)
- Number and percentage of children age 0-17 with current diabetes by income level (NSCH)
- Number and percentage of children age 0-17 with current diabetes by special health care needs status (NSCH)
- Medicaid as % of total population (NSCH)
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- Number of hospital admissions and ED visits with diagnosis code for diabetes among children ages 0-17 (MAX)
- Number of hospital admissions and ED visits with diagnosis code for diabetes among children ages 0-17 by race/ethnicity (MAX)
- Mean Medicaid expenditures per hospital admission/ED visit (MAX)
- Mean Medicaid expenditures per hospital admission/ED visit by race/ethnicity (MAX)
- Total Medicaid expenditures for hospital admissions and ED visits (MAX)
- Total Medicaid expenditures for hospital admissions and ED visits by race/ethnicity (MAX)
- Number of aggregate costs and mean cost per discharge for hospitalizations for diabetes with complications, and separately for diabetes without complications with Medicaid as payer (HCUPNet, 2011)
- Number of ED visits with first-listed diagnosis code of diabetes with complications, and separately for first-listed diagnosis diabetes without complications for people enrolled in Medicaid, all ages. (HCUPNet, 2010)
- Hospital admissions/ED visits with diagnosis code for diabetes as percentage of total Medicaid expenditures for hospital admissions and ED visits for children age 0-17 (MAX)
- Medicaid costs for discharges for diabetes as % of total Medicaid costs for hospital discharges for children (HCUPNet, 2011)
- Aggregate costs and mean cost per discharge for diabetes with complications, and separately for diabetes mellitus without complications all payers (HCUPNet, 2011)
- Medicaid as percentage of total (all-payer) discharges and aggregate costs for diabetes with complications, and separately for diabetes without complications (HCUPNet, 2011)
- Number of ED visits with first-listed diagnosis code of diabetes mellitus with complications, and separately for first-listed diagnosis code of diabetes mellitus without complications for children age 1-17, all payer (HCUPNet, 2010)
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| 20. Follow-Up After Hospitalization for Mental Illness ages 6+ |
- Number of Medicaid/CHIP enrollees age 6-20 with a hospital or other inpatient or residential admission for a mental health disorder (MAX)
- Number of Medicaid/CHIP enrollees age 6-20 with a hospital or other inpatient or residential admission for a mental health disorder by race/ethnicity (MAX)
- Existing Literature
- Children age 6-20 with an admission for a mental health disorder as % of all Medicaid/CHIP enrollees age 6-20 (MAX)
- Children age 6-20 with an admission for a mental health disorder as % of all Medicaid/CHIP enrollees age 6-20 by race/ethnicity (MAX)
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- Number of admissions for children age 6-20 for hospital admissions with a diagnosis code for a mental health disorder (MAX)
- Number of admissions for children age 6-20 for hospital admissions with a diagnosis code for a mental health disorder by race/ethnicity (MAX)
- Mean Medicaid expenditures per admission for children age 6-20 for hospital admissions with a diagnosis code for a mental health disorder (MAX)
- Mean Medicaid expenditures per admission for children age 6-20 for hospital admissions with a diagnosis code for a mental health disorder by race/ethnicity (MAX)
- Total Medicaid expenditures for children age 6-20 for hospital admissions with a diagnosis code for a mental health disorder (MAX)
- Total Medicaid expenditures for children age 6-20 for hospital admissions with a diagnosis code for a mental health disorder by race/ethnicity (MAX)
- Medicaid expenditures for children age 6-20 for hospital admissions with a diagnosis code for a mental health disorder as % of total Medicaid expenditures for children age 6-20 (MAX)
- Medicaid expenditures for children age 6-20 for hospital admissions with a diagnosis code for a mental health disorder as % of total Medicaid expenditures for children age 6-20 by race/ethnicity (MAX)
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