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2004 National Healthcare Quality Report

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Chapter 4. Timeliness

Importance and Measures

Timeliness, or the ability to receive care when needed1, is one of the six aims for improving health care quality established by the Institute of Medicine. Long waits in doctors' offices and emergency departments and in getting treatments and tests define the elements of measuring and understanding timeliness in the health care system2.

Morbidity and Mortality

  • Lack of timeliness can result in emotional distress, physical harm, and financial consequences for patients3.
  • Early intervention, whether with percutaneous coronary stenting or thrombolytic therapy, is regarded as the best chance for protecting heart muscle damage in patients suffering heart attacks4.
  • Stroke patients' mortality and long-term disability are largely influenced by the timeliness of therapy5, 6.
  • Timely delivery of appropriate care can help reduce mortality and morbidity for both acute conditions such as heart attacks and chronic conditions such as chronic kidney disease7-9.

Cost

  • Early care for comorbid conditions such as depression has been shown to reduce hospitalization rates and costs for Medicare beneficiaries10.
  • Early care for complications in patients with diabetes can reduce overall costs of the disease. 11 Some research suggests that complications can amount to nearly $50,000 per patient over 30 years.12
  • Timely outpatient care can reduce admissions for pediatric asthma, which account for $835 million in total hospitalization charges annually13, 14.

Measures

This report focuses on two of the nine measures in the timeliness measure set:

  • Time to initiation of thrombolytic therapy for heart attack patientsi
  • Patient's perceptions of the timeliness of appointments for routine care and illness care

i These measures are described in the Heart Disease section of Chapter 2.

 

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