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HHS Issues National Reports on Quality and Disparities in the Use of Health Care Services

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HHS Press Release Date: December 22, 2003

HHS Secretary Tommy G. Thompson today released two reports that represent the first national comprehensive effort to measure the quality of health care in America and differences in access to health care services for priority populations.

The reports, the National Healthcare Quality Report and the National Healthcare Disparities Report, provide baseline views of the quality of health care and differences in use of the services. Future reports will help the nation make continuous improvements by tracking quality through a consistent set of measures that will be updated as new measures and data become available.

"We need to make sure that we are building a healthier America by improving the quality of health care and ensuring that all our citizens benefit from the advantages that our health care system offers," Secretary Thompson said. "Assessing health care quality highlights our successes in reaching that goal, but more importantly, it shows us where we have more work to do and how we can make sure that all Americans benefit from scientific advances and technological innovations."

The reports point to an important priority for HHS to ensure that all Americans have the safest, highest-quality health care services possible available to them when needed. They were prepared by HHS' Agency for Healthcare Research and Quality (AHRQ) as directed by Congress.

The reports present data on the quality of, and differences in the access to, services for seven clinical conditions, including cancer, diabetes, end-stage renal disease, heart disease, HIV and AIDS, mental health, and respiratory disease. The reports also include data on maternal and child health, nursing home and home health care, and patient safety.

The measures included in the reports provide an important snapshot of the American health care system. The National Healthcare Quality Report offers hopeful signs in many areas (select for summary). For example:

  • The majority of women are screened for breast cancer (70 percent of women over 40 within the past two years) and cervical cancer (81 percent of women 18 and over within the past three years).
  • Almost 90 percent of in-center kidney dialysis patients get adequate dialysis.
  • Approximately 83 percent of women have prenatal care in their first trimester.
  • Over 80 percent of Medicare enrollees hospitalized with pneumonia get blood cultures before they are given an antibiotic, get their initial antibiotic within 8 hours, and get the type of antibiotics they need consistent with current clinical guidelines.

The report also indicates that greater improvement in health care quality is possible. For example:

  • Rates of children who are admitted to the hospital for asthma are 29.5 per 10,000.
  • Only about 20 percent of patients prescribed a medication to treat diagnosed depression have at least 3 recommended follow up visits to monitor their medication in the 12 weeks after diagnosis.
  • Sixty-two percent of smokers who had a routine office visit reported that their doctors had advised them to quit. At the same time, less than half of acute heart attack patients who smoke are counseled to quit while in the hospital (42 percent).
  • Rates for blood pressure screening are 90 percent, and rates for cholesterol screening in adults 45 or older are more than 80 percent. However, only about 25 percent of people with high blood pressure have it under control.

The National Healthcare Disparities Report presents data on the same clinical conditions and other measures as the Quality Report as they apply to the priority populations, including women; children; the elderly; racial and ethnic minority groups; low income groups; residents of rural areas; and individuals with special health care needs, specifically children with special needs, people with disabilities, people in need of long-term care, and people requiring end-of-life care. (Select for summary.)

The report found that priority populations do as well or better than the general population in some aspects of health care.

  • Asians and Pacific Islanders, American Indians/Alaskan Natives, and Hispanics have a lower death rate from all cancers.
  • Blacks have higher rates of Pap smears and blood pressure monitoring and lower rates of post-operative hip fractures compared with whites.
  • Black and Hispanic patients are more likely to report that their health care provider usually asks about medications prescribed by other doctors.
  • Hispanics and Asians and Pacific Islanders have lower rates of hospitalization from influenza.

However, there is room for improvement in other areas. For example:

  • People of lower socioeconomic status (SES) and blacks have higher death rates for all cancers combined.
  • Hispanics and American Indians and Alaska Natives are less likely to have their cholesterol checked.
  • People of lower SES and some minorities are less likely to have a usual source of care.
  • Rates of hospital admissions for conditions that are usually treatable outside the hospital are generally higher for people who live in low income areas compared with those who live in high income areas.

"The data in these reports provide an important message for the nation—we are making progress in enhancing health care quality and access, but we can do more, and we need to do more" said Carolyn M. Clancy, AHRQ's director. "The first editions of these reports, and those that follow, are an important key to meeting that challenge."

The reports are available on a new Web site, http://www.innovations.ahrq.gov. Launched today, the site serves as a Web-based clearinghouse to make it easier for health care providers, health plans, policymakers, purchasers, patients and consumers to take effective steps to improve quality. Print copies of the reports also can be obtained by calling 1-800-358-9295 or by E-mailing AHRQPubs@ahrq.hhs.gov.

Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

For more information, please contact the AHRQ Press Office: (301) 427-1855.


 

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