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2007 National Healthcare Quality Report—At A Glance
The quality of health care in this Nation continues to improve at a modest pace. However, the rate of improvement appears to be slowing. The average annual rate of improvement reported across the core measures included in this year's fifth annual National Healthcare Quality Report (NHQR) is 2.3%, based on data spanning 1994 to 2005. An analysis of selected core measures, which cover data from 2000 to 2005, shows that quality has slowed to an annual rate of 1.5%.
An important goal of improving health care quality is to reduce variation in care delivery across the country. This means that patients in all States would receive the same level of high quality, appropriate care. Since 2000, on average, variation has decreased across the measures for which the NHQR tracks State data, but this progress is not uniform. For example:
- The percentage of heart attack patients who were counseled to quit smoking has increased from 42.7% in 2000-2001 to 90.9% in 2005. Moreover, 48 States, Puerto Rico, and the District of Columbia all performed above 80% on this measure in 2005.
- Yet, in 2000, diabetic patients in the worst performing State versus the best performing State were admitted to the hospital 7.6 times more often with their diabetes out of control. By 2004, this difference had doubled to 14. If all States had reached the level of the top four best performing States, at least 39,000 fewer patients would have been admitted for uncontrolled diabetes in 2004, with a potential cost savings of $216.7 million.
One of the key functions of the NHQR is to track the Nation's progress in providing safe health care. Five years after the first NHQR, and 7 years after the Institute of Medicine's landmark publication To Err Is Human, it is still difficult to document progress, although more information than ever now exists on patient safety. From 2000 to 2005, patient safety improved at an annual rate of only 1%.
Measuring efficiency in health care is complex and often depends on one's perspective. This NHQR offers an initial evaluation of efficiency at the national level, providing several data-based perspectives on its possible measurement. There is still much room for progress in advancing the development of better measurement tools that can help assess whether Americans are obtaining true value in health care.