Prehospital care is generally provided by emergency medical services (EMS) and, includes 911 and dispatch, emergency medical response, field assessment and care, and transport (usually by ambulance or helicopter) to a hospital and between health care facilities.
M140
Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES)
2012-2019
The measure may not distinguish licensed EMTs and paramedics from those that are licensed, practicing, and affiliated. BLS and other national data sources have been shown to undercount certain types of health professionals, and may differ considerably from the estimates available from state licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.
M331
National Highway Traffic Safety Administration (NHTSA), State NEMIS Progress Reports: State & Territory Version 2 Information
2015 & 2019
The quality of local data submissions is not well documented and may vary across communities and states. Data submissions may not reflect the extent to which data are used to inform EMS system improvements.
M349
National Association of State EMS Officials
2013-2018, 2020-2021
Other legal actions such as EMAC and state emergency declarations may enable cross-border EMS practice without REPLICA.
M350U
National Highway Traffic Safety Administration (NHTSA), Fatality Analysis and Reporting System (FARS)
2015-2019
Selected states fail to record response times for all fatal events.
M350R
National Highway Traffic Safety Administration (NHTSA), Fatality Analysis and Reporting System (FARS)
2015-2019
Selected states fail to record response times for all fatal events.
Hospital and physician services refers to care for a patient who is formally admitted (or “hospitalized”) to an institution for treatment and/or care and stays for a minimum of one night in the hospital or other institution.
M147
Centers for Medicare & Medicaid Services (CMS), Timely and Effective Care-State
2013-2019
The measure does not evaluate the severity of the patients' conditions, or the nature of their treatment between emergency department arrival and discharge.
M148
Centers for Medicare & Medicaid Services (CMS), Timely and Effective Care-State
2013-2020
The measure does not evaluate the hospital's capacity to move patients from the emergency department to inpatient care during a mass casualty or other event.
M152
American Hospital Association (AHA), AHA Annual Survey of Hospitals data and U.S. Census population data analyzed by PMO personnel.
2012-2018
The measure does not evaluate the quality or comprehensiveness of care provided by the trauma centers.
M160
U.S. Health Resources & Services Administration (HRSA), Area Health Resources Files (AHRF)
2011-2018
The measure does not consider mutual aid plans that may be in place for health care facilities to supplement the number of available physicians and surgeons in the event of an emergency.
M167
National Council of State Boards of Nursing (NCSBN), National Nursing Database
2013-2016, 2018-2021
The measure does not consider mutual aid plans that may be in place to supplement the number of available RNs and LPNs in the event of an emergency. The source data may undercount the RNs and LPNs available to provide care during an emergency due to limited or non-reporting by some states.
M168
American Burn Association (ABA) data on Burn Care Facilities analyzed by PMO personnel.
2014 & 2018
The measure does not evaluate the specialized resources needed for surge capacity when an emergency results in a large number of burn patients.
M296
American Hospital Association (AHA), Annual Survey of Hospitals
2012-2018
The measure does not consider hospital geriatric services provided through contractual arrangements, the program's capacity to provide services during an emergency, or whether high quality care is provided to geriatric patients without having a designated specialty program.
M297
American Hospital Association (AHA), Annual Survey of Hospitals
2012-2018
The measure does not evaluate the quality of services provided, or the program's capacity to provide services during an emergency.
M298
American Hospital Association (AHA), Annual Survey of Hospitals
2012-2018
The measure does not consider mutual aid plans that may be in place to supplement the number of available AIIR beds in the event of an emergency.
M299
The Commonwealth Fund, Scorecard on State Health System Performance
2011-2018
Variation in state population health, such as obesity or smoking rates, may have a greater effect on the measure results than prevention and preparedness programs.
M300
The Leapfrog Group, Hospital Safety Score (HSS)
2013-2020
The measure source data does not include critical access hospitals, specialty hospitals, pediatric hospitals, hospitals in Maryland, territories exempt from public reporting to CMS, and others. Critical Access hospitals are facilities with no more than 25 beds and located in a rural area further than 35 miles from the nearest hospital, and/or are located in a mountainous region.
Long-term care refers to a continuum of medical and social services designed to support the needs of people living permanently or for an extended period in a residential setting with chronic health problems that affect their ability to perform everyday activities. This includes skilled nursing facilities, rehabilitation services, etc.
M308
Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages
2014-2021
The measure source data are collected during a specific two-week period and do not take into account variations related to season, region, resident acuity, skill mix of other care providers, and other factors. The measure does not evaluate staff availability for a disaster or whether staff received disaster response training.
M309
Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages
2014-2021
The measure source data are collected during a specific two-week period and do not take into account variations related to season, region, resident acuity, skill mix of other care providers, and other factors. The measure does not evaluate staff availability for a disaster or whether staff received disaster response training.
M307
Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages
2013-2021
Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on health care facilities may be marginal in the event of a major disaster.
M310
Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages
2014-2021
The measure source data are collected during a specific two-week period and do not take into account variations related to season, region, resident acuity, skill mix of other care providers, and other factors. The measure does not evaluate staff availability for a disaster or whether staff received disaster response training.
M303B
CMS Nursing Facility Inspection Reports
2014-2020
Nursing facility inspectors may vary in their ability to detect meaningful deficiencies in emergency plans.
M23NH
Centers for Disease Control and Prevention (CDC). National Outbreak Reporting System. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC. Update date <15Jan2020>.
2012-2019
States vary in their ability to detect and report outbreaks in long-term care settings.
M880
Centers for Medicare & Medicaid Services (CMS), Nursing Home Compare, Health Deficiencies
2017-2020
Since this measure is dependent upon government health inspectors evaluating and citing nursing homes for failing to ensure that all workers follow infection prevention and control rules, a cited deficiency is a function of the availability and diligence of inspectors.
Mental and behavioral health care is the provision and facilitation of access to medical and mental/behavioral health services including: medical treatment, substance abuse treatment, stress management, and medication with the intent to restore and improve the resilience and sustainability of health, mental and behavioral health, and social services networks. It includes access to information regarding available mass care services for at-risk individuals and the entire affected population.
M316
American Hospital Association (AHA), Annual Survey of Hospitals
2012-2018
The measure source data does not have a standard definition of emergency psychiatric services, and survey respondents may have different interpretations for positive responses. All hospital emergency medical services include emergency psychiatric services, but fewer hospitals have more complete, specialty-staffed, comprehensive psychiatric emergency services. Negative responses may indicate the absence of any emergency psychiatric services, or the absence of a separate, identifiable, comprehensive service. The measure does not evaluate the extent of service integration with other disaster preparedness and response efforts by the hospital or emergency psychiatric service, or the disaster-related services provided such as mobile crisis response capacity and telephone-based crisis services.
M317
The Henry J. Kaiser Family Foundation, Mental Health Care Health Professional Shortage Areas (HPSA) & Designated Health Professional Shortage Areas Statistics, Designated HPSA Quarterly Summary, U.S. Dept. of Health and Human Services
2014, 2016-2020
The measure data is based on the availability of psychiatrists, and does not include other behavioral health professionals (e.g., psychologists, social workers, licensed counselors, pastoral counselors, psychiatric nurses) who provide the majority of behavioral health services following disasters. The measure does not consider the ability of a state to temporarily move mental health resources within the state in response to a disaster, such as state trained and certified crisis teams that can be activated and deployed to disaster zones and rapidly supplement local resources. In addition, the measure does not evaluate lack of provider availability and readiness during disasters due to appointment waiting lists, contractual obligations to serve certain populations, or their status of skills and training necessary for optimal performance in disasters.
M800
U.S. Census Bureau and Health Resources & Services Administration (HRSA) data analyzed by PMO personnel.
2015-2020
The measure data is estimated based on matching U. S. Census area definitions with the geographic boundaries for HRSA Mental Health Professional Shortage Areas.
Home care is clinical and nonclinical care that allows a person with special needs to stay in their home. It may also be assumed to include the management of patient care needs for those patients not sick enough to require hospitalization or long-term care, or for whom hospitalization is not deemed to be of benefit. Other examples of home care include, but are not limited to: skilled nursing visits, respiratory care services, provision of durable medical equipment, hospice, and pharmacist services.
M291
Centers for Medicare & Medicaid Services (CMS), Home Health Care-State by State Data
2013-2020
Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on health care facilities may be marginal in the event of a major disaster.
M292
Centers for Medicare & Medicaid Services (CMS), Home Health Care-State by State Data
2013-2020
The measure does not evaluate the quality of the services provided including length of service delays.
M293
American Community Survey (ACS), 1-year Public Use Microsample (PUMS) data analyzed by PMO personnel (3-year average)
2012-2019
The measure does not evaluate availability of home health aide services during a health emergency, or whether providers have emergency care plans for their clients.
