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National Healthcare Disparities Report, 2004

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Timeliness

Timely care delivers appropriate medical services when they are needed. It reduces waits and sometimes harmful delays for both those who receive and those who give care. Delays in care are not uncommon. For example, while patients seek care from emergency departments for different reasons and with varying levels of urgency, they wait an average of 45 minutes to see a physician. Those with emergent conditions (i.e., conditions that should be cared for in less than 15 minutes) wait an average of 24 minutes53. Precise estimates of the human costs of delayed care are not available. Overcrowding in emergency rooms leads to higher death and revisit rates54, some of which may be related to delays in treatment. The precise costs of delayed care are also not known. People who have a primary care provider have lower long-term health care costs55,56, perhaps in part related to more timely access to care. Timely care is particularly important for patients hospitalized for medical emergencies.

Figure 2.12. Percent of Medicare beneficiaries hospitalized for pneumonia who receive antibiotics within 4 hours of arrival (top) and hospitalized for acute myocardial infarction who receive aspirin within 24 hours of admission (bottom), by race/ethnicity, 2001-2002

Pneumonia

Figure 2.12. Percent of Medicare beneficiaries hospitalized for pneumonia who receive antibiotics within 4 hours of arrival, by race/ethnicity, 2001-2002. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Acute myocardial infarction

Figure 2.12. Percent of Medicare beneficiaries hospitalized for acute myocardial infarction who receive aspirin within 24 hours of admission, by race/ethnicity, 2001-2002. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Source: CMS Quality Improvement Organization program, 2001-2002.

Reference population: Elderly Medicare beneficiaries hospitalized for pneumonia (top) or acute myocardial infarction (bottom).

Note: White, Black, API, and AI/AN are non-Hispanic groups. For findings related to all timeliness measures, go to Tables 2.11a and 2.11b. Available data do not support analyses stratified by SES.

  • The prompt administration of antibiotics can save lives and reduce lengths of stay for pneumonia. The proportion of elderly Medicare beneficiaries hospitalized for pneumonia who received antibiotics within 4 hours of arrival was lower among black and Hispanic elderly and higher among API elderly compared with non-Hispanic white elderly (Figure 2.12, top).
  • Aspirin should be given immediately to patients with heart attacks. The proportion of elderly Medicare beneficiaries hospitalized for acute myocardial infarction who received aspirin within 24 hours of admission was lower among black and Hispanic elderly and higher among API elderly compared with non-Hispanic white elderly (Figure 2.12, bottom).

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Patient Centeredness

Patient centered care is respectful of and responsive to individual patient preferences, needs, and values and ensures that patient values guide all clinical decisions. Measures of patient centeredness tracked in the NHDR include:

  • Patient-provider communication
  • Patient-provider relationship

For findings related to all measures of patient centeredness, go to Table 2.12a and Table 2.12b at the end of this chapter. Patient-provider communication and relationship are discussed in the section on patient perceptions of care in Chapter 3, Access to Health Care.

 

 

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