National Healthcare Disparities Report - LDI Health Economist

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Highlights n Disparities in quality of care are common: o Adults age 65 and over received worse care than adults ages 18-44 for 39% of quality measures. o Blacks received worse care than Whites for 41% of quality measures. o Asians and American Indians and Alaska Natives (AI/ANs) received worse care than Whites for about 30% of quality measures. o Hispanics received worse care than non-Hispanic Whites for 39% of measures. o Poor people received worse care than high-income people ii for 47% of measures. Figure H.2. Number and proportion of all access measures for which members of selected groups experienced better, same, or worse access to care compared with reference group Better Same Worse 100 80 4 7 5 3 4 2 Percent 60 40 20 0 65+ vs. 18-44 (n=11) 8 9 8 8 2 6 1 Black vs. White (n=19) Asian vs. White (n=18) 17 12 3 AI/AN vs. White (n=13) Hispanic vs. NHW (n=19) Poor vs. High Income (n=19) Key: AI/AN = American Indian or Alaska Native; NHW = non- Hispanic White; n = number of measures. Better = Population had better access to care than reference group. Same = Population and reference group had about the same access to care. Worse = Population had worse access to care than reference group. n Disparities in access are also common, especially among AI/ANs, Hispanics, and poor people: o Adults age 65 and over rarely had worse access to care than adults ages 18-44. o Blacks had worse access to care than Whites for 32% of access measures. o Asians had worse access to care than Whites for 17% of access measures. o AI/ANs had worse access to care than Whites for 62% of access measures. o Hispanics had worse access to care than non-Hispanic Whites for 63% of measures. o Poor people had worse access to care than high-income people for 89% of measures. ii Throughout the Highlights, poor indicates individuals whose household income is below the Federal poverty level and high income indicates individuals whose household income is at least four times the Federal poverty level. 4 National Healthcare Disparities Report, 2011
Highlights Quality Is Improving; Access and Disparities Are Not Improving Suboptimal health care is undesirable, but we may be less concerned if we observe evidence of vigorous improvement. Hence, the second key function of the reports is to examine change over time. To track the progress of health care quality and access in this country, the reports present annual rates of change, which represent how quickly quality of and access to services delivered by the health care system are improving or declining. Another way to describe rate of change is the speed of improvement or decline in health care quality and access. As in past reports, regression analysis is used to estimate annual rate of change for each measure. Annual rate of change is calculated only for measures with at least 4 years of data. For most measures, trends include data points from 2002-2003 to 2007-2008. New this year, we use weighted least squares regression to assess whether trends are statistically significant. Rates that are going in a favorable direction at a rate exceeding 1% per year and statistically significant are considered to be improving. Rates going in an unfavorable direction at a rate exceeding 1% per year and statistically significant are considered to be worsening. Rates that are changing less than 1% per year or that are not statistically significant are considered to be static. Because of the addition of significance testing, this year’s results cannot be compared with results in previous reports. Figure H.3. Number and proportion of all quality measures that are improving, not changing, or worsening, overall and for select populations Improving No Change Worsening 100 80 84 26 79 61 39 78 41 60 Percent 40 20 0 Total (n=151) 57 22 56 10 3 12 4 5 8 65+ (n=51) Black (n=147) 52 Asian (n=117) AI/AN (n=68) 24 54 Hispanic (n=140) 34 6 Poor (n=81) Key: AI/AN = American Indian or Alaska Native; n = number of measures. Improving = Quality is going in a positive direction at an average annual rate greater than 1% per year. No Change = Quality is not changing or is changing at an average annual rate less than 1% per year. Worsening = Quality is going in a negative direction at an average annual rate greater than 1% per year. National Healthcare Disparities Report, 2011 5
Page 1: NATIONAL HEALTHCARE DISPARITIES REP
Page 4 and 5: Acknowledgments The NHQR and NHDR a
Page 6 and 7: National Healthcare Disparities Rep
Page 8 and 9: Highlights New this year, the Highl
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Page 42 and 43: Introduction and Methods With rapid
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Effectiveness of Care Treatment: Re
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Effectiveness of Care Chronic Kidne
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Effectiveness of Care Figure 2.13.
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Effectiveness of Care Diabetes Impo
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Effectiveness of Care Multivariate
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Effectiveness of Care Focus on Indi
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Effectiveness of Care HIV and AIDS
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Effectiveness of Care To normalize
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Effectiveness of Care HIV/AIDS core
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Effectiveness of Care Mental Health
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Effectiveness of Care NEW Musculosk
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Effectiveness of Care n In all year
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Effectiveness of Care NEW Managemen
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Effectiveness of Care Lifestyle Mod
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Effectiveness of Care Functional St
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Effectiveness of Care at admission
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Effectiveness of Care Supportive an
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Effectiveness of Care n The 2008 to
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Effectiveness of Care References 20
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Effectiveness of Care Centers for M
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140 National Healthcare Disparities
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Patient Safety To Err Is Human does
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Patient Safety Figure 3.1. Adult su
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Patient Safety Also, in the NHQR: n
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Patient Safety n From 2006-2007 to
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Patient Safety Chapter 3 n From 200
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Timeliness Findings Getting Care fo
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Patient Centeredness Chapter 5 Simi
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178 National Healthcare Quality Rep
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Care Coordination Importance Chapte
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Care Coordination n In 2009, Americ
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Efficiency Findings Chapter 7 Inapp
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Health System Infrastructure Eviden
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Access to Health Care Findings Heal
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U.S. Department of Health and Human
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