Research Activities, June 2013
AHRQ’s new reports show care quality slowly improving and large disparities in access to care
The quality of health care in the United States improved slowly between 2002 and 2009. Yet, access to health care remained a great challenge for some Americans, according to new reports recently released by AHRQ.
The 2012 National Healthcare Quality Report and National Healthcare Disparities Report found that, prior to the passage of the Affordable Care Act, Americans received recommended prevention and treatment services only 70 percent of the time. Access to care in 2009—the latest year for which most data were available—was "far from optimal" for many Americans, especially racial and ethnic minorities and low-income people.
Overall, 26 percent of Americans reported facing barriers that restricted their access to care. Blacks and Hispanics received worse care than whites on about 40 percent of quality measures. Blacks had worse access to care than whites on about 33 percent of access measures and Hispanics had worse access to care than whites on about 70 percent of access measures.
Affordable Care Act addresses barriers to access to care
The reports' quality and access data predate passage of the Affordable Care Act, which addresses many of the barriers people now face when accessing health care. Already, the Affordable Care Act has improved access to health care for more than 3 million additional young adults who can remain enrolled in their parents' health insurance plans until age 26. This includes an estimated 913,000 Latino, 509,000 African American and 121,000 Asian young people.
"These reports underscore the need for improving access to high-quality care," said AHRQ Director Carolyn M. Clancy, M.D. "These reports underscore the need for improving access to high-quality care."
"Fortunately, the Affordable Care Act is helping to address these gaps in coverage. As the Affordable Care Act offers more Americans a wider variety of critically important services, Americans' health will improve, especially given the law's quality and safety provisions."
"As the Affordable Care Act offers more Americans a wider variety of critically important services, Americans' health will improve." Some improvements in quality of care were identified, including surgical patients' receipt of appropriate care, appropriate timing of antibiotics for surgical patients, and appropriate timing of pneumonia and influenza screenings or vaccinations among hospital patients
Reports call for urgent attention to certain areas
However, the reports call for "urgent attention" to ensure continued improvements for diabetes care, maternal and child health care, and treatment for conditions such as pressure ulcers and blood clots. For example, in 2009, only 23 percent of adults 40 and older with diabetes received all four recommended services (at least two hemoglobin tests, foot exam, dilated eye exam, and flu shot). Black and Hispanic adults with diabetes were less likely than whites to receive that recommended care. More than 250 measures relating to quality of care and access to health services are factored in and reported by racial, ethnic, and socioeconomic groups. The data are compiled from more than 45 national sources.
New measures included in this year's reports
Included in this year's reports are new measures on early and adequate prenatal care, colorectal cancer screening, national rate of hospital-acquired conditions, standardized infection ratios at the State level for central line-associated bloodstream infections, and patient safety culture hospital survey findings. This year marks the 10th anniversary that AHRQ has produced the quality and disparities reports, which are mandated by Congress. Since their initial publication in 2003, overall health care quality has improved by about 3 percent annually between 2002 and 2009. Yet access to care and disparities related to racial and socioeconomic factors have remained the same or even worsened during the same period.
To view the 2012 National Healthcare Quality Report and National Healthcare Disparities Report, visit www.ahrq.gov/research/findings/nhqrdr.
In addition, AHRQ's NHQRDRnet is an online query system that provides access to national and State data on the quality of, and access to, health care from scientifically credible measures and data sources. To use the interactive tool, visit http://nhqrnet.ahrq.gov.