The good news in the 2011 National Healthcare Quality Report and National Healthcare Disparities Report is that certain areas of care have improved. For example, cardiac care has significantly improved in areas such as reduced hospital admissions for congestive heart failure and fewer hospital deaths due to heart attack. Unfortunately, our Agency reports also show that overall health care improvements continue to progress at a slow rate—only 2.5 percent a year—and disparities in care persist. For example, on average people received the preventive services tracked in the reports 60 percent of the time, appropriate acute care services 80 percent of the time, and recommended chronic disease management services 70 percent of the time. On average, Americans report barriers to care 20 percent of the time.
Compared to whites, blacks received worse care for 41 percent of quality measures. Asians and American Indians and Alaska Natives (AI/ANs) received worse care for about 30 percent of quality measures, and Hispanics received worse care for 39 percent of measures. In addition, adults aged 65 and older received worse care than adults aged 18 to 44 for 39 percent of quality measures and poor people received worse care than high-income people for 47 percent of measures. Disparities in access to care also persisted for blacks, Asians, AI/ANs, Hispanics, poor people, and the elderly.
AHRQ is working closely with the Department of Health and Human Services (HHS) to accomplish the goals outlined in the HHS Action Plan To Reduce Racial and Ethnic Health Disparities (http://minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=33&ID=285) to build on the important efforts made possible the by Affordable Care Act. Also, for the first time, this year's reports are organized around the priorities outlined in the National Strategy for Quality Improvement in Health Care (http://www.healthcare.gov/law/resources/reports/nationalqualitystrategy032011.pdf; Plugin Software Help).
These priorities range from making care safer and more affordable and ensuring person- and family-centered care to working with communities to promote wide use of best practices to enable healthy living. The highlights that precede both reports include examples of rich collaboration among stakeholders, so we know that care improvement is possible. AHRQ continues to work with other stakeholders and conduct research to identify innovative strategies that can improve quality of care and reduce disparities. Approaches range from reaching out to disadvantaged and ethnic minority groups with targeted clinical and community interventions to developing tools clinicians can use to improve quality of care in the hospital, nursing home, doctor's office, or ambulatory care site. AHRQ is dedicated to rapidly improving the quality and equity of care for all Americans.
Carolyn Clancy, M.D.
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