National Healthcare Disparities Report - LDI Health Economist

More documents

Recommendations

Info

Priority Populations AHRQ’s Priority Populations AHRQ’s priority populations, specified by Congress in the Healthcare Research and Quality Act of 1999 (Public Law 106-129), are: n Racial and ethnic minority groups. ii Chapter 10 n Low-income groups. iii n Women. n Children (under age 18). n Older adults (age 65 and over). n Residents of rural areas. iv n Individuals with special health care needs, v including individuals with disabilities and individuals who need chronic care or end-of-life care. Other populations, such as LGBT, are also included. How This Chapter Is Organized This chapter provides the most recent information available on racial, ethnic, and income differences in quality and access for priority populations. It is presented in the following order: n Racial and ethnic minorities. n Low-income groups. n Residents of rural areas. n Individuals with disabilities or special health care needs. n LGBT individuals. Measures related to women, children, and older adults are integrated into other chapters of this report and the Data Tables appendix and include comparisons by gender and age. This chapter does not provide a comprehensive assessment of health care differences in each priority population. In general, most of the measures tracked in the NHQR and NHDR were selected to be applicable across many population groups to fulfill the purpose of these reports, which is to track quality and disparities at the national level. These general measures overlook some important health care problems specific to particular populations. For example, people with disabilities may face barriers in getting access to care and experience differences in quality of care that are not captured by data because of the limitations in the survey instruments. ii Racial groups are White, Black, Asian, Native Hawaiian or Other Pacific Islander, American Indian and Alaska Native, and more than one race. Ethnic groups are Hispanic or Latino, non-Hispanic White, and non-Hispanic Black. iii Thresholds for income categories—poor, low income, middle income, and high income—vary by family size and composition and are updated annually by the U.S. Bureau of the Census. For example, in 2011, the Federal poverty threshold for a family of two adults and two children was $22,350. iv Rural areas can be defined differently depending on the data source. The NHDR uses Office of Management and Budget revised definitions of metropolitan and micropolitan statistical areas. Noncore areas are rural areas. v Individuals with special health care needs include children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally. 234 National Healthcare Disparities Report, 2011
Priority Populations Racial and Ethnic Minorities In 2010, more than one-third of the U.S. population identified themselves as members of racial or ethnic minority groups (U.S. Census Bureau, 2011a). By 2050, it is projected that these groups will account for almost half of the U.S. population. The U.S. Census Bureau estimated that the United States had about 39 million Blacks or African Americans in 2010 (12.6% of the U.S. population) (U.S. Census Bureau, 2011a); more than 47.8 million Hispanics or Latinos (15.5%) (U.S. Census Bureau, 2008); almost 14.8 million Asians (4.8%); about 6.2 million NHOPIs (0.2%); and nearly 3 million AI/ANs (0.9%) (U.S. Census Bureau, 2011a), of whom 57% reside on Federal trust lands (Smedley, et al., 2003). Racial and ethnic minorities are more likely than non-Hispanic Whites to be poor or near poor (Lillie- Blanton, et al, 2003). In addition, Hispanics, Blacks, and some Asian subgroups are less likely than non- Hispanic Whites to have a high school education (Collins, et al., 2002). Previous chapters of the NHDR describe health care differences by racial and ethnic categories as defined by the Office of Management and Budget and used by the U.S. Census Bureau (Executive Office of the President, 1997). In this section, quality of and access to health care for each minority group are summarized to the extent that statistically reliable data are available for each group. Chapter 10 Criteria for importance are that the difference is statistically significant at the alpha ≤ 0.05 level (two-tailed test) and that the relative difference from the reference group is at least 10% when framed positively as a favorable outcome or negatively as an adverse outcome. Access measures focus on facilitators and barriers to health care and exclude health care utilization measures. Changes Over Time This section also examines changes over time in differences related to race and ethnicity. For each measure, racial, ethnic, and socioeconomic groups are compared with a designated comparison group. The time periods range from 2000-2002 to 2008-2010, depending on the data source. Consistent with Healthy People 2020, disparities are measured in relative terms as the percentage difference between each group and a comparison group. New this year is the use of a linear regression model to estimate the difference in the annual rate of change for the comparison group relative to the reference group. The difference in annual rate of change for the comparison group relative to the reference group was estimated. Determinations of whether subgroup differences have grown, narrowed, or remained the same were based on estimated differences in annual rate of change as specified below: n Subgroup differences are deemed to be narrowing if the change in disparities is less than −1 and p
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
Page 10 and 11:
Highlights n Disparities in quality
Page 12 and 13:
Highlights n Quality is improving s
Page 14 and 15:
Highlights Figure H.6. Number and p
Page 16 and 17:
Highlights Table H.2. Quality measu
Page 18 and 19:
Highlights n Disparities also chang
Page 20 and 21:
Highlights Figure H.9. Income-relat
Page 22 and 23:
Highlights Progress in Patient Safe
Page 24 and 25:
Highlights available to the public
Page 26 and 27:
Highlights Examples of Initiatives
Page 28 and 29:
Highlights Provider: When referring
Page 30 and 31:
Highlights State: The Ohio Plan To
Page 32 and 33:
Highlights Figure H.15. Number and
Page 34 and 35:
Highlights to have high health care
Page 36 and 37:
Highlights n Data on disparities ar
Page 38 and 39:
Highlights share experiences and di
Page 40 and 41:
Highlights References Andrulis DP,
Page 42 and 43:
Introduction and Methods With rapid
Page 44 and 45:
Introduction and Methods a new sect
Page 46 and 47:
Introduction and Methods Table 1.2.
Page 48 and 49:
Introduction and Methods antibiotic
Page 50 and 51:
Introduction and Methods Progress o
Page 52 and 53:
Introduction and Methods n Trends o
Page 54 and 55:
Introduction and Methods Reporting
Page 56 and 57:
Effectiveness of Care Cancer Import
Page 58 and 59:
Effectiveness of Care Chapter 2 Can
Page 60 and 61:
Effectiveness of Care Treatment: Re
Page 62 and 63:
Effectiveness of Care Also, in the
Page 64 and 65:
Effectiveness of Care Importance Ca
Page 66 and 67:
Page 68 and 69:
Effectiveness of Care Chapter 2 Car
Page 70 and 71:
Page 72 and 73:
Effectiveness of Care Chronic Kidne
Page 74 and 75:
Effectiveness of Care Figure 2.13.
Page 76 and 77:
Effectiveness of Care Diabetes Impo
Page 78 and 79:
Effectiveness of Care Multivariate
Page 80 and 81:
Effectiveness of Care Focus on Indi
Page 82 and 83:
Effectiveness of Care HIV and AIDS
Page 84 and 85:
Effectiveness of Care To normalize
Page 86 and 87:
Effectiveness of Care HIV/AIDS core
Page 88 and 89:
Effectiveness of Care Outcome: Deat
Page 90 and 91:
Effectiveness of Care Findings NEW
Page 92 and 93:
Page 94 and 95:
Page 96 and 97:
Effectiveness of Care Prevention: W
Page 98 and 99:
Effectiveness of Care Mental Health
Page 100 and 101:
Page 102 and 103:
Page 104 and 105:
Effectiveness of Care NEW Musculosk
Page 106 and 107:
Effectiveness of Care n In all year
Page 108 and 109:
Effectiveness of Care NEW Managemen
Page 110 and 111:
Effectiveness of Care Findings Prev
Page 112 and 113:
Page 114 and 115:
Effectiveness of Care Chapter 2 Res
Page 116 and 117:
Effectiveness of Care Lifestyle Mod
Page 118 and 119:
Effectiveness of Care n In 5 out of
Page 120 and 121:
Effectiveness of Care NEW Outcome:
Page 122 and 123:
Effectiveness of Care Chapter 2 Lif
Page 124 and 125:
Page 126 and 127:
Effectiveness of Care Functional St
Page 128 and 129:
Effectiveness of Care Chapter 2 Fun
Page 130 and 131:
Effectiveness of Care at admission
Page 132 and 133:
Effectiveness of Care Supportive an
Page 134 and 135:
Effectiveness of Care n The 2008 to
Page 136 and 137:
Effectiveness of Care Chapter 2 Sup
Page 138 and 139:
Page 140 and 141:
Effectiveness of Care References 20
Page 142 and 143:
Effectiveness of Care Centers for M
Page 144 and 145:
Effectiveness of Care Oral health i
Page 146 and 147:
140 National Healthcare Disparities
Page 148 and 149:
Patient Safety To Err Is Human does
Page 150 and 151:
Patient Safety Figure 3.1. Adult su
Page 152 and 153:
Patient Safety Also, in the NHQR: n
Page 154 and 155:
Patient Safety n From 2006-2007 to
Page 156 and 157:
Patient Safety n From 2004 to 2008,
Page 158 and 159:
Patient Safety Chapter 3 n From 200
Page 160 and 161:
Page 162 and 163:
Timeliness Findings Getting Care fo
Page 164 and 165:
Timeliness Chapter 4 n Not all pati
Page 166 and 167:
Timeliness Chapter 4 n Among heart
Page 168 and 169:
Page 170 and 171:
Patient Centeredness Chapter 5 Simi
Page 172 and 173:
Patient Centeredness Figure 5.1. Ad
Page 174 and 175:
Patient Centeredness Figure 5.3. Ch
Page 176 and 177:
Patient Centeredness Figure 5.5. Ad
Page 178 and 179:
Patient Centeredness Patient Langua
Page 180 and 181:
Patient Centeredness Information ab
Page 182 and 183:
Patient Centeredness Providers Aski
Page 184 and 185:
178 National Healthcare Quality Rep
Page 186 and 187:
Care Coordination Importance Chapte
Page 188 and 189:
Care Coordination n In 2009, Americ
Page 190 and 191: Care Coordination Figure 6.3. Paren
Page 192 and 193: Care Coordination Also, in the NHQR
Page 194 and 195: Care Coordination Chapter 6 n Overa
Page 196 and 197: Care Coordination Chapter 6 n Overa
Page 198 and 199: Efficiency Findings Chapter 7 Inapp
Page 200 and 201: Efficiency Figure 7.2. Potentially
Page 202 and 203: Efficiency Comparisons with the 3 S
Page 204 and 205: Efficiency Perforated Appendixes Pe
Page 206 and 207: Efficiency Figure 7.8. Males age 75
Page 208 and 209: 202 National Healthcare Disparities
Page 210 and 211: Health System Infrastructure Eviden
Page 212 and 213: Health System Infrastructure Figure
Page 214 and 215: Health System Infrastructure Figure
Page 216 and 217: Health System Infrastructure Occupa
Page 218 and 219: Health System Infrastructure n From
Page 220 and 221: Health System Infrastructure NEW Co
Page 222 and 223: Health System Infrastructure Table
Page 224 and 225: Health System Infrastructure Refere
Page 226 and 227: Access to Health Care Findings Heal
Page 228 and 229: Access to Health Care Figure 9.2. P
Page 232 and 233: Access to Health Care Financial Bur
Page 234 and 235: Access to Health Care Chapter 9 n O
Page 238 and 239: Priority Populations Chapter 10 232
Page 242 and 243: Priority Populations Blacks or Afri
Page 244 and 245: Priority Populations Hispanics or L
Page 246 and 247: Priority Populations Geographic are
Page 248 and 249: Priority Populations criminal justi
Page 250 and 251: Priority Populations Postponement R
Page 252 and 253: Priority Populations References Adl
Page 254 and 255: 248 National Healthcare Disparities
Page 256: U.S. Department of Health and Human
show all

National Healthcare Disparities Report - LDI Health Economist

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?