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Report finds that gaps in health care quality and access existed in 2009
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The 2009 National Healthcare Quality Report and National Healthcare Disparities Report show that improvements in patient safety continue to lag, according to a U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality press release.
The Agency for Healthcare Research and Quality’s (AHRQ’s) quality and disparities reports have been published annually since 2003. A new section in the 2009 quality report focused on health care-associated infections (HAIs).
“Despite promising improvements in a few areas of health care, we are not achieving the more substantial strides that are needed to address persistent gaps in quality and access,” Carolyn M. Clancy, MD, AHRQ director, stated in the release. “Targeted AHRQ-funded research in Michigan has shown that infection rates of HAIs can be radically reduced. We are now working to make sure that happens in all hospitals.”
In assessing HAIs, it found:
- rates of postoperative sepsis, i.e., bloodstream infections, increased by 8%;
- postoperative catheter-associated urinary tract infections increased by 3.6%;
- rates of selected infections due to medical care increased by 1.6%;
- rates of bloodstream infections associated with central venous catheter placements did not change; and
- rates of postoperative pneumonia improved by 12%.
Counseling obese patients
The reduced rates of HAIs in more than 100 Michigan hospitals were achieved by adopting a comprehensive unit-based safety program as part of a project conducted by the Michigan Health and Hospital Association Keystone Center. Since then, the AHRQ has announced funding that has expanded the project to all 50 states, Puerto Rico, and the District of Columbia, according to the release.
Overall, the study categorizes more than 200 health care measures in four areas of quality to produce the data: effectiveness, patient safety, timeliness, and patient-centeredness.
Another new section on lifestyle modifications focused on preventing and reducing obesity. The NHRQ tracked several quality measures for modifying unhealthy lifestyles, including counseling obese individuals about exercise and being overweight. The study found that: one-third of obese adults never received advice from their doctor about exercise; most overweight children and one-third of obese adults reported they were not told by their doctor that they are overweight; and most American children have never received counseling from their health care provider about exercise, and almost half have never received counseling about healthy eating.
Health insurance and quality of care
The AHRQ reported that uninsured Americans are much less likely than those who are privately insured to receive recommended care, especially preventive services and management for diabetes. Although differences between the rates of uninsured blacks and uninsured whites have decreased, disparities related to ethnicity, income and education still persist.
According to the disparities report, “[For many services] uninsurance was the single strongest predictor of quality of care, exceeding the effects of race, ethnicity, income, or education.”
- References:
National Healthcare Disparities Report. Rockville, MD: Agency for Healthcare Research and Quality, US Dept of Health and Human Services; 2009.
National Healthcare Quality Report. Rockville, MD: Agency for Healthcare Research and Quality, US Dept of Health and Human Services; 2009.
