Figure H.1. Number and proportion of all quality measures for which members of selected groups experienced better, same, or worse quality of care compared with reference group
| Quality of Care | Black vs. White (n=191) | Asian vs. White (n=165) | AI/AN vs. White (n=111) | Hispanic vs. NHW (n=178) | Poor vs. High Income (n=106) | Low vs. High Income (n=106) | Middle vs. High Income (n=106) |
|---|
| Better | 28 | 43 | 12 | 37 | 5 | 6 | 2 |
| Same | 81 | 80 | 62 | 66 | 37 | 38 | 49 |
| Worse | 82 | 42 | 37 | 75 | 64 | 62 | 55 |
Key: AI/AN = American Indian or Alaska Native; NHW = non-Hispanic White; n = number of measures.
Better = Population received better quality of care than reference group.
Same = Population and reference group received about the same quality of care.
Worse = Population received worse quality of care than reference group.
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Figure H.2. Number and proportion of all access measures for which members of selected groups experienced better, same, or worse access to care compared with reference group
| Access to Care | Black vs. White (n=21) | Asian vs. White (n=19) | AI/AN vs. White (n=14) | Hispanic vs. NHW (n=21) | Poor vs. High Income (n=21) | Low vs. High Income (n=21) | Middle vs. High Income (n=21) |
|---|
| Better | 3 | 4 | NA | 3 | NA | NA | NA |
| Same | 11 | 11 | 8 | 3 | NA | 3 | 6 |
| Worse | 7 | 4 | 6 | 15 | 21 | 18 | 15 |
Key: AI/AN = American Indian or Alaska Native; NHW = non-Hispanic White; n = number of measures.
Better = Population had better access to care than reference group.
Same = Population and reference group had about the same access to care.
Worse = Population had worse access to care than reference group.
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Figure H.3. Average performance across a panel of quality of care process measures and access to care measures
| Measure | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 |
|---|
| Did Not Receive Indicated Process of Care | NA | NA | NA | 33.6 | 31.7 | 30.6 | 30.7 | 30.1 |
| Encountered Access Problem Seeking Care | 24.1 | 24.2 | 24.3 | 24.7 | 25.2 | 25.2 | 25.4 | 26.3 |
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Figure H.4. Number and proportion of all quality measures that are improving, not changing, or worsening, overall and for select populations
| Population | Worsening | No Change | Improving |
|---|
| Total (n=152) | 16 | 51 | 85 |
| Black (n=154) | 14 | 58 | 82 |
| Asian (n=129) | 6 | 54 | 69 |
| AIAN (n=80) | 5 | 37 | 38 |
| Hispanic (n=153) | 10 | 67 | 76 |
| Poor (n=87) | 9 | 36 | 42 |
| Low Income (n=87) | 10 | 37 | 40 |
| Middle Income (n=86) | 12 | 38 | 36 |
Key:AI/AN = American Indian or Alaska Native; n = number of measures.
Improving = Quality is going in a positive direction at an average annual rate greater than 1% per year.
No Change = Quality is not changing or is changing at an average annual rate less than 1% per year.
Worsening = Quality is going in a negative direction at an average annual rate greater than 1% per year.
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Figure H.5. Number and proportion of all access measures that are improving, not changing, or worsening, overall and for select populations
| Population | Worsening | No Change | Improving |
|---|
| Total (n=15) | 7 | 7 | 1 |
| Black (n=15) | 3 | 10 | 2 |
| Asian (n=13) | NA | 13 | NA |
| AI/AN (n=10) | 3 | 7 | NA |
| Hispanic (n=15) | 2 | 11 | 2 |
| Poor (n=15) | 4 | 8 | 3 |
| Low Income (n=15) | 4 | 10 | 1 |
| Middle Income (n=15) | 8 | 5 | 2 |
Key:AI/AN = American Indian or Alaska Native; n = number of measures.
Improving = Access is going in a positive direction at an average annual rate greater than 1% per year.
No Change = Access is not changing or is changing at an average annual rate less than 1% per year.
Worsening = Access is going in a negative direction at an average annual rate greater than 1% per year.
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Figure H.6. Number and proportion of all quality measures for which disparities related to race, ethnicity, and income are improving, not changing, or worsening
| Change | Black vs. White (n=154) | Asian vs. White (n=129) | AI/AN vs. White (n=80) | Hispanic vs. NHW (n=148) | Poor vs. High Income (n=85) | Low vs. High Income (n=85) | Middle vs. High Income (n=85) |
|---|
| Worsening | 5 | 8 | 5 | 6 | 4 | 1 | 1 |
| No Change | 137 | 112 | 73 | 134 | 78 | 80 | 83 |
| Improving | 12 | 9 | 2 | 8 | 3 | 4 | 1 |
Key: AI/AN = American Indian or Alaska Native; NHW = non-Hispanic White; n = number of measures.
Improving = Disparity is getting smaller at a rate greater than 1% per year.
No Change = Disparity is not changing or is changing at a rate less than 1% per year.
Worsening = Disparity is getting larger at a rate greater than 1% per year.
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Figure H.7. Number and proportion of all access measures for which disparities related to race, ethnicity, and income are improving, not changing, or worsening
| Change | Black vs. White (n=15) | Asian vs. White (n=13) | AI/AN vs. White (n=10) | Hispanic vs. NHW (n=15) | Poor vs. High Income (n=15) | Low vs. High Income (n=15) | Middle vs. High Income (n=15) |
|---|
| Worsening | NA | NA | 1 | 1 | 1 | 1 | NA |
| No Change | 15 | 12 | 9 | 14 | 14 | 14 | 15 |
| Improving | NA | 1 | NA | NA | NA | NA | NA |
Key: AI/AN = American Indian or Alaska Native; NHW = non-Hispanic White; n = number of measures.
Improving = Disparity is getting smaller at a rate greater than 1% per year.
No Change = Disparity is not changing or is changing at a rate less than 1% per year.
Worsening = Disparity is getting larger at a rate greater than 1% per year.
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Figure H.8. Percentage of quality measures in the 2006, 2011, and 2012 reports for which a reliable estimate could not be generated
| Reports | Asian | NHOPI | AI/AN | Hispanic | Poor |
|---|
| 2006 Reports | 33 | 93 | 47 | 12 | 60 |
| 2011 Reports | 19 | 85 | 42 | 7 | 46 |
| 2012 Reports | 14 | 82 | 42 | 7 | 45 |
Key: NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native.
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Figure H.9. Number and proportion of measures that are improving, not changing, or worsening, by type of quality measure
| Measures | Worsening | No Change | Improving |
|---|
| Process Measures (n=67) | 6 | 25 | 36 |
| Outcome Measures (n=64) | 10 | 23 | 31 |
| Preventive Care (n=37) | 3 | 17 | 17 |
| Acute Treatment (n=25) | NA | 4 | 21 |
| Chronic Disease Management (n=46) | 8 | 19 | 19 |
Key:n = number of measures.
Improving = Quality is going in a positive direction at an average annual rate greater than 1% per year.
No Change = Quality is not changing or is changing at an average annual rate less than 1% per year.
Worsening = Quality is going in a negative direction at an average annual rate greater than 1% per year.
Note: Preventive care includes screening, counseling, and vaccinations; acute treatment includes hospital
care for cancer, heart attack, and pneumonia; chronic disease management includes ambulatory care
for diabetes, arthritis, and asthma and nursing home care for pressure sores and pain.
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Figure H.10a. Overall quality of care, preventive care, acute care, and chronic care, by State
| Overall quality of care |
|---|
| Lowest quality quartile | Second quartile | Third quartile | Highest quality quartile |
|---|
| Alaska | California | Hawaii | Utah |
| Nevada | Oregon | Washington | North Dakota |
| New Mexico | Arizona | Idaho | South Dakota |
| Texas | Wyoming | Montana | Minnesota |
| Oklahoma | Florida | Colorado | Wisconsin |
| Louisiana | Alabama | Nebraska | Iowa |
| Arkansas | Georgia | Kansas | Maine |
| Mississippi | Illinois | Missouri | New Hampshire |
| Kentucky | Tennessee | Michigan | Vermont |
| Indiana | Ohio | Pennsylvania | Massachusetts |
| West Virginia | North Carolina | Rhode Island | Connecticut |
| Maryland | New York | Virginia | New Jersey |
| NA | NA | South Carolina | Delaware |
Source: 2011 State Snapshots.
Note: States are divided into quartiles based on overall health care score.
Figure H.10b. Overall quality of care, preventive care, acute care, and chronic care, by State (continued)
| Quality of preventive care |
|---|
| Lowest quality quartile | Second quartile | Third quartile | Highest quality quartile |
|---|
| Oregon | Alaska | Hawaii | North Dakota |
| Nevada | California | Washington | South Dakota |
| Idaho | Utah | Arizona | Minnesota |
| New Mexico | Colorado | Nebraska | Iowa |
| Texas | Wyoming | Louisiana | Wisconsin |
| Arkansas | Montana | Michigan | Georgia |
| Missouri | Kansas | Rhode Island | Maine |
| Illinois | Oklahoma | New Jersey | New Hampshire |
| Indiana | Kentucky | Maryland | Vermont |
| Ohio | Tennessee | Virginia | Massachusetts |
| Pennsylvania | Mississippi | North Carolina | Connecticut |
| Alabama | Florida | South Carolina | New York |
| NA | West Virginia | NA | Delaware |
Source: 2011 State Snapshots.
Note: States are divided into quartiles based on overall health care score.
Figure H.10c. Overall quality of care, preventive care, acute care, and chronic care, by State (continued)
| Quality of acute care |
|---|
| Lowest quality quartile | Second quartile | Third quartile | Highest quality quartile |
|---|
| Alaska | Nevada | Washington | Idaho |
| California | Montana | Oregon | Utah |
| Wyoming | Arizona | Colorado | Minnesota |
| New Mexico | North Dakota | South Dakota | Wisconsin |
| Oklahoma | Kansas | Nebraska | Michigan |
| Arkansas | Texas | Iowa | Ohio |
| Louisiana | Illinois | Missouri | Maine |
| Alabama | Kentucky | Indiana | New Hampshire |
| Georgia | Mississippi | Tennessee | Massachusetts |
| West Virginia | Maryland | South Carolina | New Jersey |
| Rhode Island | Delaware | Pennsylvania | Virginia |
| NA | New York | Connecticut | North Carolina |
| NA | Hawaii | Vermont | Florida |
Source: 2011 State Snapshots.
Note: States are divided into quartiles based on overall health care score.
Figure H.10d. Overall quality of care, preventive care, acute care, and chronic care, by State (continued)
| Quality of chronic care |
|---|
| Lowest quality quartile | Second quartile | Third quartile | Highest quality quartile |
|---|
| New Mexico | Washington | California | Utah |
| Texas | Oregon | Montana | North Dakota |
| Oklahoma | Alaska | Colorado | South Dakota |
| Louisiana | Idaho | Arizona | Kansas |
| Indiana | Nevada | Nebraska | Minnesota |
| Ohio | Wyoming | Missouri | Iowa |
| Kentucky | Arkansas | Maine | Wisconsin |
| Tennessee | Illinois | Vermont | Alabama |
| Florida | Mississippi | Connecticut | New Hampshire |
| North Carolina | Michigan | Rhode Island | Massachusetts |
| West Virginia | Georgia | New Jersey | Delaware |
| New York | South Carolina | Pennsylvania | Hawaii |
| NA | Maryland | Virginia | NA |
Source: 2011 State Snapshots.
Note: States are divided into quartiles based on overall health care score.
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