In a new report published this month, the Agency for Healthcare Research and Quality (AHRQ), a research agency within the U.S. Department of Health and Human Services (HHS), presents data showing that hospitals are leading the movement to improve the quality of care delivered to U.S. patients, outpacing improvements in other settings. According to the report, three-quarters of hospital quality measures showed significant improvement, compared with 60% for home health and nursing home care, and about half for ambulatory settings.
The U.S. Department of Health and Human Services (HHS) Partnership for Patients initiative, HHS’ Centers for Medicare & Medicaid Services (CMS) quality reporting programs, such as the Hospital Inpatient Quality Reporting Program and Hospital Outpatient Quality Reporting Program, and private-sector initiatives such as those sponsored by the Institute for Healthcare Improvement have been catalysts for the current quality improvement effort in hospitals.
Hospitals are clearly engaged in efforts to improve health care quality in the United States
“Hospitals are clearly engaged in efforts to improve health care quality inthe United States,” said AHRQ DirectorRichard Kronick, Ph.D. “The intense national focus on quality improvement in hospitals is starting to pay off, but much work remains to make sure that all Americans have access to high-quality care in every setting.”
Recommended Medical Services
The 2013 National Healthcare Quality Report and National Healthcare Disparities Reportshow that Americans are receiving recommended medical services 70% of the time. The reports include data based on hundreds of health care measures categorized in several areas of quality. These are effectiveness, patient safety, timeliness, patient-centeredness, care coordination, efficiency, health system infrastructure and access. This marks the 11th year AHRQ has reported on the state of national health care quality and disparities.
The reports also indicate that public reporting of quality measures through venues such as CMS’ Hospital Compare website may have contributed to improvements. Fourteen of the 16 quality measures that reached a 95 percent performance level were publicly reported by CMS. Another four CMS measures are among those improving at the fastest pace. Every CMS measure tracked in the reports and publicly reported on the Hospital Compare Web site showed improvement over time, compared with 60 percent of hospital measures that are not publicly reported by CMS.
Consistent reporting
Consistent with other national reports?including aCMS report released May 7, 2014?rates of some healthcare-associated infections, or HAIs, are beginning to fall while processes to prevent hospital readmission are improving. Quality also has improved for measures on adolescent vaccination, HIV treatment, colon cancer surgical care and hospital care for patients with heart problems and pneumonia. Quality worsened for measures on diabetes checkups, Pap smears, maternal deaths at delivery and preventive care for patients with asthma.
The reports include trend data for most measures of quality and disparities from 2000-2002 to 2010-2011, which predate implementation of most of the Medicaid expansions and health insurance exchanges under the Affordable Care Act. The reports provide a baseline for tracking progress under the Affordable Care Act in upcoming years.
Deficiencies in Access
The reports also found deficiencies regarding health care access, with 26% of Americans (especially racial and ethnic minorities and low-income people) reporting difficulties getting care. Most disparities in quality of care that were related to race, ethnicity or income showed no significant change. However, for blacks, Hispanics, Asians and poor people, the number of disparities showing improvement was larger than the number of disparities that were getting worse.
Each year since 2003, AHRQ has reported on the progress and opportunities for improving health care quality and reducing health care disparities. The National Healthcare Quality Report focuses on national trends in the quality of health care provided to the American people, while the National Healthcare Disparities Report focuses on prevailing disparities in health care delivery as they relate to racial and socioeconomic factors in priority populations.
For more information
Quality and disparities reports are available online at NHQRnet,
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