The limited improvements in health care
The quality of health care has improved an average of 2.3 year between 1994 and 2005, the index shows that although some important progress, said a general slowdown of the improvement in quality, according to annual reports reported today by the Agency for Healthcare Research and Quality Agency (Research and Quality Health Care AHRQ-as its initials in English).
The rate of improvement published in the National Report on Quality of Health Care and the National Report on Disparities in Health Care for 2007 is below the average annual rate of improvement of 3.1 percent published in the reports of 2006 . Those reports measured trends between 1994 and 2004 measures. The rates of quality improvement are less than fully documented cost increases in health care. Centers of Care and Health Care estimated that expenditures on health care rose an average 6.7 percent annually over the same period. “The quality of health care increases only weakly as much,” said AHRQ Director Dr. Carolyn Clancy. “Given that expenditures on health care are increasing at a rate much faster, these findings about quality underscore the urgent need to improve the value Americans are getting for their investment in the care health. Every year, the reports from AHRQ Quality and Disparities update national trends in the provision of health care.
The analysis assesses the quality and disparities in four areas: effectiveness of care, patient safety, timeliness of care and concentration in the patient. The reports of 2007, the 5th. edition since its first publication in 2003, identifies some major improvements such as better care for patients with heart disease. In determining what percentage of patients with heart attacks were subjected to analysis recommended, or are receiving medication indicated to quit, reports indicated an average annual rate of improvement of 5.6% between 2002 and 2005. For their part, the safety assessment of the patients recorded an average annual increase of just 1 percent. This small increase reflects measurements such as the proportion of elderly patients to whom he had been given potentially harmful prescription drugs, as well as the number of patients who suffered surgical complications.
The reports also showed some reduction in disparities in care based on race, ethnicity and income. For example, while Hispanics are more likely than whites to suffer delays in care or not receiving any attention, the disparity decreased between 2000 and 2001 and between 2004 and 2005. Moreover, while black children between 19 and 35 months of age are less likely than white children to receive all the recommended vaccines, that disparity also decreased. In general, however, still many of the most important disparities. Black children under 18 are 3.8 times more likely that white children to be hospitalized for asthma. New AIDS cases are 3.5 times more likely among Hispanics than among whites. Among pregnant women, the potential of Indian or Alaska Native to receive prenatal care during the first three months are 2.1 times smaller. The Quality and Disparities Reports of AHRQ, which were ordered by Congress, are read widely on the part of policymakers, analysts, health care, public health advocates, health insurers, journalists and consumers. The National Report on Quality of Health Care for this year synthesizes more than 200 “quality measures”, ranging from the number of pregnant women received prenatal care until the percentage of residents of nursing facilities and rehabilitation were controlled by physical restraints.
For its part, the National Report on Disparities in Health Care summarizes what racial, ethnic or income benefit from the improvements in care. The reports for 2007 are based on data collected from more than three dozen databases, most sponsored by federal health agencies. The findings included: * More than 93 percent of heart attack patients received recommended hospital care, which means an increase in the rate of approximately 77 per cent in 2000/2001. The percentage of patients with heart attacks who are recommended to quit smoking increased from about 43 per cent in 2000/2001 to about 91 percent in 2005.
Lack of health insurance can have a significant impact on the quality of health care. For example, only 18 percent of people without health insurance went to the dentist at least once a year, compared with 51 percent of those who had private health insurance. Only 38 percent of women without health insurance mammograms were performed in the last two years, compared with 74 percent of those without insurance. * About 26 percent of adults with disabilities-basic disabilities that impede mobility or other basic functions, suffer delays in care or not receiving any attention, compared with 11 percent of people without disabilities. About 23 percent of seniors with disabilities took inappropriate medications compared with 13 percent of seniors without disabilities. * Of the people who needed treatment for illicit drug in 2005, only 18 percent of those between 18 and 44 years actually received treatment.
Only 11 percent of children between 12 and 17 years received treatment. These indices practically have not changed since 2002. The Quality and Disparities Reports are available online at www.ahrq.gov/qual/qrdr07.htm (in English), by calling 1-800-358-9295 or sending an email to ahrqpubs@ahrq.hhs . gov. The quality report serves as a basis for future State Snapshots (Screenshots of the States), published in the spring, which details the changes in trends in the quality of health care between different states.