2010 National Healthcare Quality & Disparities Reports

Clive Riddle, March 4, 2011

HHS’ Agency for Healthcare Research and Quality (AHRQ) has just issued the 2010 National Healthcare Quality Report and National Healthcare Disparities Report. The reports are published annually, as mandated by Congress since 2003.

AHRQ tells us the “reports show trends by measuring health care quality for the Nation using a group of credible core measures. The data are based on more than 200 health care measures categorized in several areas of quality: effectiveness, patient safety, timeliness, patient-centeredness, care coordination, efficiency, health system infrastructure, and access.”

AHRQ summarizes the report findings as indicating “that few disparities in quality of care are getting smaller, and almost no disparities in access to care are getting smaller. Overall, blacks, American Indians and Alaska Natives received worse care than whites for about 40 percent of core measures. Asians received worse care than whites for about 20 percent of core measures. And Hispanics received worse care than whites for about 60 percent of core measures. Poor people received worse care than high-income people for about 80 percent of core measures. Of the 22 measures of access to health care services tracked in the reports, about 60 percent did not show improvement, and 40 percent worsened. On average, Americans report barriers to care one-fifth of the time, ranging from 3 percent of people saying they were unable to get or had to delay getting prescription medications to 60 percent of people saying their usual provider did not have office hours on weekends or nights. Among disparities in core access measures, only one—the gap between Asians and whites in the percentage of adults who reported having a specific source of ongoing care—showed a reduction.”

My impression of the state of things is evidenced in a section header entitled: “Quality Is Improving; Access and Disparities Are Not Improving.” The report states found that “across all 179 measures of health care quality tracked in the reports, almost two-thirds showed improvement. However, median rate of change was only 2.3% per year. Access is not improving. Across the 22 measures of health care access tracked in the reports, about 60% did not show improvement and 40% were headed in the wrong direction.”

Of course, patterns of care are regional, not national. The report found that “while every State was in the top 10% for some measure and was part of a benchmark, States in the New England (CT, MA, ME, NH, RI, VT) and Pacific (AK, CA, HI, OR, WA) census divisions were benchmark States most often and States in the East North Central (IL, IN, MI, OH, WI), East South Central (AL, KY, MS, TN), and West South Central (AR, LA, OK, TX) divisions were benchmark States less often.

The full 205 page National Healthcare Quality Report addresses: Effectiveness of Care, Patient Safety, Timeliness of Care, Patient Centeredness, Care Coordination, Efficiency of Care, Health System Infrastructure and Access to Health Care. The full 248 page National Healthcare Disparities Report addresses the same topic plus a section on Priority Populations. There is considerable overlap in the content of the two companion reports.

The reports are definitely worth some clicks to check them out.