AHRQ
releases 2005
National Healthcare Quality
and Disparities Reports
Quality of health
care for Americans has continued to improve at a modest
pace, and health care disparities are narrowing overall for
many minority Americans. But for Hispanics, disparities have
widened in both quality of care and access to care,
according to reports by HHS' Agency for Healthcare Research
and Quality (AHRQ).
The findings are
contained in the
2005 National Healthcare Quality Report
and its companion document, the
2005 National Healthcare Disparities Report.
These reports, issued annually, measure quality and
disparities in four key areas of health care: effectiveness,
patient safety, timeliness, and patient centeredness.
The quality report
employs a wide range of measures, including health care
outcomes such as hospital-acquired infections and reductions
in deaths from certain diseases. It also measures how well
the health care system is using specific treatments that are
known to work most effectively. The disparities report
compares these measures by race and ethnicity and by income.
It also measures access to care, using indicators such as
health insurance status and frequency of visits to a
physician. This year, for the first time, the report also
shows trends in health care disparities from year to year.
The
2005 National Healthcare Quality Report
finds that overall quality of care for all Americans
improved at a rate of 2.8 percent, the same increase shown
in last year's report. However, the report notes there has
been much more rapid improvement in some measures,
especially where there have been focused efforts to improve
care.
The
2005 National Healthcare Disparities Report
finds that many of the largest disparities in measures of
quality and access are observed for low-income people
regardless of race or ethnicity, with some signs of
improvement. Overall, more racial disparities in quality of
care were narrowing than were widening, and most racial
disparities in access to care were narrowing (affecting
blacks, Asians and American Indians/Alaska Natives). But for
Hispanics, the majority of disparities for both quality and
access were growing wider.
"The quality
report finds modest overall progress in quality of care for
Americans and areas where we must continue to work to close
health care gaps. Faster progress is especially apparent
where focused efforts, including public reporting of quality
results, have taken place," said AHRQ Director Carolyn
Clancy, M.D. "It is clear that the need for action to
improve quality of care for all Americans continues to be
great."
Examples of
findings in the AHRQ disparities report include:
Rates of
late-stage breast cancer decreased more rapidly from 1992 to
2002 among black women (169 to 161 per 100,000 women) than
among white women (152 to 151 per 100,000), resulting in a
narrowing disparity.
Treatment of heart
failure improved more rapidly from 2002 to 2003 among
American Indian Medicare beneficiaries (69 percent to 74
percent) than among white Medicare beneficiaries (73 percent
to 74 percent), resulting in an elimination of this
disparity.
The quality of
diabetes care declined from 2000 to 2002 among Hispanic
adults (44 percent to 38 percent) as it improved among white
adults (50 percent to 55 percent).
The quality of
patient-provider communication (as reported by patients
themselves) declined from 2000 to 2002 among Hispanic adults
(87 percent to 84 percent) as it improved among white adults
(93 percent to 94 percent).
Access to a usual
source of care increased slightly from 1999 to 2003 for
Hispanics (77 percent to 78 percent) and whites (88 percent
to 90 percent), with Hispanics less likely to have access to
a usual source of care.
The report finds a
10.2 percent annual improvement in the five core measures of
patient safety. These are areas where coordinated national
efforts are underway to improve the delivery of specific
"best practice" treatments to improve patient safety and
reduce medical errors.
"In many areas, we
know the specific treatment steps and procedures that are
needed to improve quality. These reports indicate that when
we focus on those best practices, we can make rapid
improvement, especially when results are publicly reported,"
Dr. Clancy said.
Improvements were
greatest in quality measures for diabetes, heart disease,
respiratory conditions, nursing home care, and maternal and
child health care. The overall rate of change for these
measures was 5.4 percent.
Dr. Clancy said
the findings in the report can help target efforts more
effectively to improve quality and reduce disparities.
"These reports are a complex picture of our progress so far.
They can help target where improvement is most needed and
help show us how to bring those improvements about," she
said.
The reports were
issued today at the National Leadership Summit on
Eliminating Racial and Ethnic Disparities in Health,
sponsored by the HHS Office of Minority Health. The summit
marks the 20th anniversary of the issuance of the Report of
the Secretary's Task Force on Black and Minority Health,
which led to new efforts to improve the health and health
care of minority Americans.
The AHRQ reports are available online at
www.qualitytools.ahrq.gov, by
calling 1-800-358-9295 or by sending an email to
ahrqpubs@ahrq.gov.