National Healthcare Disparities Report - LDI Health Economist

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Highlights State: The Ohio Plan To Prevent Heart Disease and Stroke outlines an approach to reducing the burden of cardiovascular disease through lifestyle improvement, risk factor reduction, acute care, rehabilitation, and surveillance. Objectives include increasing State laws, partners, and schools that promote physical activity, healthy eating, and a smoke-free environment; increasing work site programs to control high blood pressure and cholesterol; improving prehospital and inpatient treatment of cardiovascular events; increasing facilities that provide cardiac and stroke rehabilitation; and increasing reporting of and access to data related to quality and disparities (Edwards, et al., 2009). Provider: In the HealthyHeartClub.com program, pharmacists help patients reduce cardiovascular risk and reach goals related to diet, physical activity, and medication adherence. Support includes group classes, e- mail check-ins, and Web tools to track progress toward goals. Participants have increased physical activity and reduced weight and blood pressure (HCIE #3182). For older patients after a heart attack or bypass surgery, Massachusetts General Hospital and University of California San Francisco combine followup phone calls from an advanced practice nurse with home visits from a trained elder to encourage compliance with medications and lifestyle changes. The program improves medication adherence and reduces readmissions due to cardiac-related complications (HCIE #1823). National Priority: Working With Communities To Promote Wide Use of Best Practices To Enable Healthy Living Population health is influenced by many factors, including genetics, lifestyle, health care, and physical and social environments. The NHQR and NHDR focus on health care and counseling about lifestyle modification and do not address biological and social determinants of health that are currently not amenable to alteration through health care services. Still, it is important to acknowledge that the fundamental purpose of health care is to improve the health of populations. Acute care is needed to treat injuries and illnesses with short courses, and chronic disease management is needed to minimize the effects of persistent health conditions. But preventive services that avert the onset of disease, foster the adoption of healthy lifestyles, and help patients to avoid environmental health risks hold the greatest potential for maximizing population health. This NQS priority aligns best with the lifestyle modification sections in the Effectiveness chapters in the NHQR and NHDR. However, screening for cancer and cardiovascular risk factors are found in the Cancer and Cardiovascular Disease sections of the chapter, respectively. Childhood vaccinations are found in the Maternal and Child Health section while adult vaccinations are found in the section on Respiratory Diseases. The NQS identifies several important opportunities for success in promoting healthy living: increasing the provision of clinical preventive services for children and adults and increasing the adoption of evidencebased interventions to improve health. The HHS Disparities Action Plan includes this priority under its strategies to reduce disparities in population health by increasing the availability and effectiveness of community-based programs and policies. 24 National Healthcare Disparities Report, 2011
Highlights Progress in Healthy Living Figure H.14. Number and proportion of measures that are improving, not changing, or worsening, immunizations versus screening and counseling 100 Improving No Change 80 10 7 Worsening 60 Percent 40 20 0 6 10 1 1 Childhood and Adult Immunizations (n=17) Screening and Counseling (n=18) Key: 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. Note: Screening includes screening for cancer and high cholesterol; counseling includes advice from a provider about exercise and diet. n Immunization rates are improving while clinical preventive services are lagging: o Trends could be assessed for 6 childhood and 11 adult vaccination measures. Of these, 59% were improving, similar to health care quality overall (56%). o Trends could be assessed for 6 screening and 12 counseling services related to healthy living. Of these measures, 39% showed improvement, a lower rate than health care quality overall. National Healthcare Disparities Report, 2011 25
Page 1: NATIONAL HEALTHCARE DISPARITIES REP
Page 4 and 5: Acknowledgments The NHQR and NHDR a
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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 Centeredness Chapter 5 Simi
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Care Coordination Importance Chapte
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U.S. Department of Health and Human
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