Health Care Quality Still Improving Slowly, But Disparities and Gaps in Access to Care Persist

Electronic Newsletter, Issue 308

March 10, 2011

AHRQ News and Numbers

Insurers and consumers spent $52.2 billion on prescription drugs in 2008 for outpatient treatment of metabolic conditions such as diabetes and elevated cholesterol. Metabolic medicines were the class of drugs with the highest level of spending in 2008. [Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #313: Expenditures for the Top Five Therapeutic Classes of Outpatient Prescription Drugs, Adults Age 18 and Older, U.S. Civilian Noninstitutionalized Population, 2008.]

Today's Headlines

  1. Health care quality still improving slowly, but disparities and gaps in access to care persist
  2. AHRQ released Common Formats for patient safety reporting in skilled nursing facilities
  3. New resource list helps hospitals get up to speed on safety culture
  4. Behavioral counseling interventions to promote a healthful diet and physical activity
  5. AHRQ's Health Care Innovations Exchange offers innovative solutions to adverse drug events
  6. Delivering patient-centered outcomes research to the Nation's free clinics
  7. Audio podcasts keep you updated on health care information
  8. Highlights from our most recent monthly newsletter
  9. AHRQ in the professional literature

1. Health Care Quality Still Improving Slowly, But Disparities and Gaps in Access to Care Persist

Improvements in health care quality continue to progress at a slow rate—about 2.3 percent a year; however, 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 released by AHRQ. 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. Few disparities in quality of care are getting smaller, and almost no disparities in access to care are getting smaller, according to the report. 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. Select to access the quality and disparities . Print copies are available by sending an E-mail to ahrqpubs@ahrq.hhs.gov.

2. AHRQ Released Common Formats for Patient Safety Reporting in Skilled Nursing Facilities

AHRQ released new Common Formats for patient safety reporting in skilled nursing facilities. These new formats complement an existing set of Common Formats, Version 1.1, that are designed to help health care providers collect both generic and event-specific information about incidents, near misses and unsafe conditions in hospital settings. The term "Common Formats" refers to the common definitions and reporting formats, specified by AHRQ, that allow health care providers to collect and submit standardized information regarding patient safety events. The Common Formats apply to all patient safety concerns, including incidents, near misses or close calls, and unsafe conditions. Future versions of the Common Formats are being developed for ambulatory settings, such as surgery centers and medical offices. All of the Skilled Nursing Facilities Formats are currently available as in beta versions for public review and comment via the AHRQ Patient Safety Organization Web site.

3. New Resource Helps Hospitals Get Up To Speed on Safety Culture

Hospitals working to improve the safety culture of their organization have a new Web-based resource that provides practical information on the patient safety dimensions used in AHRQ's Hospital Survey on Patient Safety Culture (HSOPS). The resource is organized by the dimensions assessed in the HSOPS, such as teamwork within units, overall perceptions of safety, and feedback and communication about errors. It contains links to useful tools and examples that organizations can use to help improve their safety culture. A list of general resources from leading public and private groups involved in patient safety is also included. Select to access the resource.

4. Behavioral Counseling Interventions to Promote a Healthful Diet and Physical Activity

The U.S. Preventive Services Task Force is inviting public comment on its draft recommendation statement on behavioral counseling interventions to promote a healthful diet and physical activity for cardiovascular disease prevention in adults. This draft recommendation is an update of the Task Force 2002 recommendation on behavioral counseling in primary care to promote physical activity and a partial update of its 2003 recommendation on behavioral counseling in primary care to promote a healthy diet. the part of the recommendation that dealt with counseling patients at risk of cardiovascular disease was not updated at this time.) The deadline to comment is March 22.

5.AHRQ's Health Care Innovations Exchange Offers Innovative Solutions to Adverse Drug Events

This week's issue from AHRQ's Health Care Innovations Exchange offers health care professionals innovative approaches to reducing Adverse Drug Events (ADEs), including improving health literacy, employing safety mentors, and using pharmacists to provide telephone-based medication reconciliation. ADEs result in more than 770,000 injuries and deaths each year and cost up to $5.6 million per hospital, depending on its size. Hospitals can reduce these events and their associated costs by making system changes focused on prevention and early detection. AHRQ has several tools and resources available to help those interested learn how to detect and prevent medication errors. Select to read this issue and more on the AHRQ Health Car Innovations Exchange Web site.

6. Delivering Patient-Centered Outcomes Research to the Nation's Free Clinics

Join AHRQ Director Dr. Carolyn Clancy and Nicole Lamoureux, Executive Director of the National Association of Free Clinics (NAFC) when they discuss how patient-centered outcomes research/comparative effectiveness tools and decision aids can benefit the nation's free clinics. AHRQ and NAFC will host a free webinar on March 30, at 2:00 p.m., EDT to describe AHRQ's Effective Health Care Program and ways patient-centered outcomes research can improve care for America's most vulnerable populations. If you work with a free clinic are interested in volunteering with a free clinic, or want to learn more this session is for you. Select to register.

7. Audio Podcasts Keep You Updated On Health Care Information

AHRQ's Healthcare 411 is a podcast series you can listen to at home or on the go. Weekly 60-second audio podcasts, available in English and Spanish, are designed for consumers. Log on and listen to Healthcare 411; or subscribe and we'll send stories directly to your computer or personal media player. Select to listen to our latest audio podcast keeping kids in school via telemedicine.

8. Highlights from Our Most Recent Monthly Newsletter

The March issue of Research Activities is available online. Key articles include:

  • Re-engineered discharge project dramatically reduces return trips to the hospital.

    The last place patients want to end up after a hospital stay is right back in the hospital. But millions of patients each year are readmitted to hospitals, and many of those stays could have been prevented. In fact, 4.4 million hospital stays each year are due to potentially preventable readmissions. In 2006, Boston University Medical Center's Brian Jack, M.D., an AHRQ grantee, decided to tackle the problem of these preventable readmissions. His focus was on the discharge process. By applying engineering methods such as probabilistic risk assessment, process mapping, failure mode and effects analysis, qualitative analysis, and root cause analysis, he and his colleagues were able to get a clear picture of patient discharges. Select to read this article.

Other articles include:

  • Better adherence to diabetes medications means fewer hospitalizations and emergency department visits.
  • Kidney stone rates in children may be on the rise.
  • Expert workshop discusses disparities in health care quality and role of health IT in underresourced settings.
  • Better hospital quality of care for the elderly is associated with lower mortality after discharge.

Select to read these articles and others.

9. AHRQ in the Professional Literature

We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.

Galanter W, Liu XF, Lambert BL. Analysis of computer alerts suggesting oral medication use during computerized order entry of i.v. medications. Am J Health Syst Pharm 2010 Jul 1; 67(13):1101-5. Select to access the abstract on PubMed®.

Morgan DJ, Liang SY, Smith CL, et al. Frequent multidrug-resistant Acinetobacter baumannii contamination of gloves, gowns, and hands of healthcare workers. Infect Control Hosp Epidemiol 2010 Jul; 31(7):716-21. Select to access the abstract on PubMed®.

Carpenter WR, Howard DL, Taylor YJ, et al. Racial differences in PSA screening interval and stage at diagnosis. Cancer Causes Control 2010 Jul; 21(7):1071-80. Select to access the abstract on PubMed®.

Turchin A, Goldberg SI, Shubina M, et al. Encounter frequency and blood pressure in hypertensive patients with diabetes mellitus. Hypertension 2010 Jul; 56(1):68-74. Select to access the abstract on PubMed®.

Kimmel AD, Weinstein MC, Anglaret X, et al. Laboratory monitoring to guide switching antiretroviral therapy in resource-limited settings: clinical benefits and cost-effectiveness. J Acquir Immune Defic Syndr 2010 Jul 1; 54(3):258-68. Select to access the abstract on PubMed®.

Moon RY, Oden RP, Joyner BL, et al. Qualitative analysis of beliefs and perceptions about sudden infant death syndrome in African-American mothers: implications for safe sleep recommendations. J Pediatr 2010 Jul; 157(1):92-7.e2. Select to access the abstract on PubMed®.

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Current as of March 2011
Internet Citation: Health Care Quality Still Improving Slowly, But Disparities and Gaps in Access to Care Persist. March 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/308.html