National Healthcare Disparities Report - LDI Health Economist

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Timeliness Chapter 4 n Among heart attack patients, the percentage of patients receiving timely PCI improved for all racial/ethnic groups from 2005 to 2009 (Figure 4.4). In all years, Blacks and Hispanics were less likely than Whites to receive timely PCI. n The 2008 top 5 State achievable benchmark was 91%. i At the current rate of improvement, the achievable benchmark could be attained overall in less than 1 year. n All racial/ethnic groups should reach the achievable benchmark in less than a year. Also, in the NHQR: n From 2005 to 2009, among heart attack patients, a significantly higher percentage of patients under age 65 received PCI within 90 minutes than patients of all other age groups. Figure 4.5. Hospital patients with heart attack who received fibrinolytic medication within 30 minutes, by race/ethnicity, 2005-2009 100 White Black Hispanic Asian 80 60 2008 Achievable Benchmark: 61% Percent 40 20 0 2005 2006 2007 2008 2009 Source: Centers for Medicare & Medicaid Services, Medicare Quality Improvement Organization Program, 2005-2009. Denominator: Patients hospitalized with a principal diagnosis of acute myocardial infarction who were appropriate candidates for fibrinolytic medication. n Among heart attack patients, the percentage of patients receiving timely fibrinolytic medication improved for all racial/ethnic groups from 2005 to 2009 (Figure 4.5). In all years, Blacks were less likely to receive timely fibrinolytic medication compared with Whites. n In 2008, the top 5 State achievable benchmark was 61%. ii At the current rate of improvement, the achievable benchmark could be attained in about 1.5 years. n At their current rates of improvement, Whites should reach the achievable benchmark in a little over 1 year; Hispanics should reach the benchmark in about 2 years, and Blacks should reach the benchmark in about 3 years. i The top 5 States that contributed to the achievable benchmark are Massachusetts, Minnesota, North Carolina, Rhode Island, and South Carolina. ii The top 5 States that contributed to the achievable benchmark are Arkansas, California, Georgia, Kentucky, and Tennessee. 160 National Healthcare Disparities Report, 2011
Timeliness Also, in the NHQR: n From 2005 to 2009, in 4 of 5 years, a significantly higher percentage of heart attack patients under age 65 received fibrinolytic medication within 30 minutes than patients age 75 and over. References Boudreau RM, McNally C, Rensing EM, et al. Improving the timeliness of written patient notification of mammography results by mammography centers. Breast J 2004 Jan-Feb;10(1):10-19. Calculated from Web site: Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project. Kids’ Inpatient Database. Rockville, MD. Available at: http://hcupnet.ahrq.gov/. Accessed April 24, 2009. Caro JJ, Ward AJ, O’Brien JA. Lifetime costs of complications resulting from type 2 diabetes in the U.S. Diabetes Care 2002 Mar;25(3):476-81. Centers for Disease Control and Prevention. National Hospital Ambulatory Medical Care Survey: 2008 emergency department summary tables. Available at http://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/nhamcsed2008.pdf. Accessed May 9, 2011. Himelhoch S, Weller WE, Wu AW, et al. Chronic medical illness, depression, and use of acute medical services among Medicare beneficiaries. Med Care 2004 Jun;42(6):512-21. Houck PM, Bratzler DW. Administration of first hospital antibiotics for community-acquired pneumonia: does timeliness affect outcomes Curr Opin Infect Dis 2005 Apr;18(2):151-6. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academies Press; 2001. Kinchen KS, Sadler J, Fink N, et al. The timing of specialist evaluation in chronic kidney disease and mortality. Ann Intern Med 2002 Sep 17;137(6):479-86. Kloner RA, Rezkalla SH. Cardiac protection during acute myocardial infarction: where do we stand in 2004 J Am Coll Cardiol 2004 Jul 21;44(2):276-86. Kwan J, Hand P, Sandercock P. Improving the efficiency of delivery of thrombolysis for acute stroke: a systematic review. QJM 2004 May;97(5):273-9. Luman ET, Barker LE, Shaw KM, et al. Timeliness of childhood vaccinations in the United States: days undervaccinated and number of vaccines delayed. JAMA 2005 Mar 9;293(10):1204-11. Niska R, Bhuiya F, Xu J, et al. National Hospital Ambulatory Medical Care Survey: 2007 emergency department summary. Natl Health Stat Report 2010 Aug 6 (26). Available at: http://www.cdc.gov/nchs/data/nhsr/nhsr026.pdf. Accessed February 1, 2012. Ramsey SD, Newton K, Blough D, et al. Patient-level estimates of the cost of complications in diabetes in a managed-care population. Pharmacoecon 1999 Sep;16(3):285-95. Chapter 4 National Healthcare Disparities Report, 2011 161
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U.S. Department of Health and Human
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