While improvements in health care quality slowly continue to progress, disparities based on race and ethnicity, socioeconomic status, and other factors persist at unacceptably high levels, according to the 2010 National Healthcare Quality Report and National Healthcare Disparities Report issued this week by the Department of Health & Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ).
Gains in health care quality were seen in a number of areas, with the highest rates of improvement in measures related to treatment of acute illnesses or injuries. For example, the proportion of patients with heart attack who underwent procedures to unblock heart arteries within 90 minutes improved from 42% in 2005 to 81% in 2008.
Other very modest gains were seen in rates of screening for preventive services and child and adult immunization. However, measures of lifestyle modifications such as preventing or reducing obesity, smoking cessation, and substance abuse saw no improvement.
The reports indicate 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% of core measures. Asians received worse care than whites for about 20% of core measures. And Hispanics received worse care than whites for about 60% of core measures. Poor people received worse care than high-income people for about 80% of core measures.
Of the 22 measures of access to health care services tracked in the reports, about 60% did not show improvement, and 40% worsened. On average, Americans report barriers to care one-fifth of the time, ranging from 3% of people saying they were unable to get or had to delay getting prescription medications to 60% 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.
The reports, which are mandated by Congress, 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.
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