‘Sub­op­ti­mal care’

Re­port shows lit­tle im­prove­ment for mi­nori­ties

Modern Healthcare - - THE WEEK IN HEALTHCARE - Mau­reen Mckin­ney

The news from the fed­eral gov­ern­ment’s lat­est com­pan­ion re­ports on health­care qual­ity and dis­par­i­ties mir­rored the find­ings of past ver­sions: Qual­ity is im­prov­ing, al­beit slowly, but per­sis­tent racial, eth­nic and eco­nomic dis­par­i­ties show lit­tle im­prove­ment.

Re­leased an­nu­ally since 2003 by HHS’ Agency for Health­care Re­search and Qual­ity, the re­ports draw on a wide range of data— more than 40 sources for these lat­est re­ports—to make con­clu­sions about health­care sys­tem qual­ity and gaps in care. The re­ports cover 2002 through 2008, with some data from 2009.

The qual­ity re­port showed an over­all me­dian im­prove­ment of 2.5% across the health­care sys­tem, about the same rate of change re­ported in pre­vi­ous years.

“The ma­jor takeaways are very sim­i­lar to what we have shown in the past,” said Dr. Ernest Moy, med­i­cal of­fi­cer in AHRQ’S Cen­ter for Qual­ity Im­prove­ment and Pa­tient Safety. “Qual­ity of care con­tin­ues to be sub­op­ti­mal. It does im­prove over the vast num­ber of mea­sures, but the rate of im­prove­ment is vari­able and it is much slower than we would want.”

The news from the dis­par­i­ties re­port was even bleaker, Moy said. Of the mea­sures used to track dis­par­i­ties in health­care ac­cess, roughly half showed no im­prove­ment and 40% showed a de­cline. Asians, Amer­i­can In­di­ans and Alaska Na­tives re­ceived worse care than whites for 30% of the clin­i­cal qual­ity mea­sures in the re­port, and that num­ber jumped to 41% for black pa­tients.

Re­duc­ing dis­par­i­ties re­quires bet­ter ac­cess to care, ac­tive en­gage­ment from pa­tients and tai­lored in­ter­ven­tions that tar­get spe­cific pop­u­la­tions, Moy says.

In an April 20 news re­lease an­nounc­ing the re­ports, AHRQ Di­rec­tor Dr. Carolyn Clancy pre­dicted that the pro­vi­sions of the health­care re­form law would help to en­sure more eq­ui­table care. Moy agreed, but he added that the ef­fects of the law would not be ap­par­ent in the re­ports for sev­eral years.

Moy said the data in this year’s and next year’s re­ports will serve as a base­line mea­sure of the health­care sys­tem be­fore the re­form law’s poli­cies be­gin to roll out.

“First, we’ll be­gin to see im­prove­ments in the rates of unin­sured, and then later, hope­fully, in ac­cess to care,” he said. “Later, we en­vi­sion im­prove­ments in qual­ity of care and then, even fur­ther down the road, im­prove­ments in health out­comes. This is over the long term.”

Moy re­fused to spec­u­late about the out­come of the pend­ing le­gal chal­lenges to the health­care re­form law, but he did ex­press op­ti­mism that mo­men­tum to­ward im­prove­ment is grow­ing re­gard­less of the U.S. Supreme Court’s decision.

“We’re mov­ing into an era when providers and pa­tients in­creas­ingly ac­cept the no­tion that we have to pay at­ten­tion to qual­ity and dis­par­i­ties,” Moy said. “No mat­ter what hap­pens from a le­gal per­spec­tive, that is not go­ing to change.”

This year, AHRQ used HHS’ Na­tional Qual­ity Strat­egy as a frame­work for high­light­ing trends in the data. Un­veiled in March 2011, the NQS iden­ti­fied six top pri­or­i­ties, in­clud­ing safer care, in­creased

pa­tient-cen­tered­ness, care co­or­di­na­tion and af­ford­abil­ity. In a 2011 news re­lease, HHS said the strat­egy would func­tion as “an evolv­ing guide for the na­tion as we con­tinue to move for­ward with ef­forts to mea­sure and im­prove health and health­care qual­ity.” << Mayra Al­varez, di­rec­tor of public health pol­icy in HHS’ Of­fice of Health Re­form, speaks last week, pro­mot­ing HHS’ ef­forts to im­prove mi­nor­ity health on the heels of a re­port show­ing per­sis­tent dis­par­i­ties in the care mi­nori­ties re­ceive.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.