National Healthcare Disparities Report - LDI Health Economist

More documents

Recommendations

Info

Highlights n Data on disparities are improving but still suboptimal: o The percentage of quality measures that could not be used to assess disparities decreased for all groups. o For Native Hawaiians and Other Pacific Islanders and multiple race individuals, reliable estimates were not available for more than half of the measures, making any assessment of disparities incomplete. Reliable estimates for AI/ANs and poor populations also could not be generated for a large percentage of measures. Examples of Initiatives Increasing Data on Racial and Ethnic Minority Populations Federal: The Affordable Care Act requires that all federally funded health programs and population surveys collect and report data on race, ethnicity, and primary language and supports use of data to analyze and track health disparities (Andrulis, et al., 2010). To improve the quality of data collected in population surveys, HHS published Data Standards for Race, Ethnicity, Sex, Primary Language, and Disability in October 2011 (Office of Minority Health, 2011). New standards for race and ethnicity expand upon but roll up to the 1997 Office of Management and Budget data collection standards (minorityhealth.hhs.gov/templates/content.aspxID=9227&lvl=2&lvlID=208). To strengthen data collection in Medicaid and Children’s Health Insurance Programs, HHS evaluated these programs and recommended improvements in the report Approaches for Identifying, Collecting, and Evaluating Data on Health Care Disparities in Medicaid and CHIP. Recommendations include aligning the Medicaid Statistical Information System, Medicare Current Beneficiary Survey, and Consumer Assessment of Healthcare Providers and Systems with the new data standards (www.healthcare.gov/law/resources/reports/disparities09292011a.pdf). State: In Massachusetts, all acute care hospitals are required to collect information on race and ethnicity from every patient with an inpatient stay or emergency department visit. Hospitals must use a standardized set of race categories as well as 31 ethnicity categories, and the State provides a tool to assist with collection (Weinick, et al., 2007). The Wisconsin Health Care Information Section has collaborated with various stakeholders to improve collection of information on race and ethnicity. It worked with AI/AN Tribes and the State’s cancer database to cross-reference tribal clinic data. It also worked with a leading Hmong organization to distribute a patient brochure in English and Hmong highlighting the importance of reporting ethnicity to hospitals (Hanlon & Raetzman, 2010). Provider: Aetna began collecting data on race and ethnicity from members in 2002, the first major health plan to do so. Information is collected electronically and on paper forms. More than 60 million Aetna members have provided data on race, ethnicity, and primary language. The Alliance of Chicago Community Health Services developed an EHR that merges clinical data with standardized race and ethnicity data stored in the practice management system. This allows assessments of disparities across the four participating community health centers (IOM, 2009). 30 National Healthcare Disparities Report, 2011
Highlights Summary Across National Priorities and Next Steps Table H.5. Summary of progress on national priorities Making Progress Progress Lagging Lacking Sufficient Data Ensuring Person- and Making Care Safer Promoting Effective Care Coordination Family-Centered Care Promoting Effective Prevention and Promoting Healthy Living Making Quality Care More Affordable Treatment of Cardiovascular Disease Increasing Data on Racial and Ethnic Minority Populations n Making Care Safer: Most measures improving but more slowly than other hospital measures. n Ensuring Person- and Family-Centered Care: Quality generally high; most measures improving. n Promoting Effective Prevention and Treatment of Cardiovascular Disease: Quality generally high; almost all measures improving. n Promoting Healthy Living: Most measures improving, but screening and counseling about lifestyle modification improving more slowly than other quality measures. n Promoting Effective Care Coordination and Making Quality Care More Affordable: Measures and data are limited; more information is needed to assess performance. n Increasing Data on Racial and Ethnic Minority Populations: Availability of data is improving slowly but data are still insufficient to assess disparities for many groups. n Disparities: Persistent in all national priorities. Critical steps to advance the NQS and achieve further gains on the priorities include stakeholder engagement, agency-specific quality improvement plans, and harmonization and alignment of metrics for ongoing benchmarking and reporting of progress. Stakeholder Engagement and Goal Setting Legislation requires the NQS to be shaped by input from stakeholders wielding collective national influence to ensure a nationally achievable, impact-oriented strategy. A large focus over the past year has been work by the National Quality Forum (NQF) to convene the multistakeholder National Priorities Partnership (NPP), a partnership of 48 public-and private-sector partners. NPP provided collective input on specific goals, measure concepts with illustrative measures, and highest value strategic opportunities to accelerate improvement across all priorities to NQF, which wrote the draft report. Released in September 2011, the final report, Input to the Secretary of Health and Human Services on Priorities for the National Quality Strategy (NPP, 2011), provides valuable suggestions for moving forward. Work over the coming year will include alignment of efforts on specific goals, measures, and strategic opportunities. HHS also convened the Interagency Working Group (IWG), as mandated by the ACA, for its inaugural meeting in March 2011. The IWG, composed of representatives from 24 Federal agencies with qualityrelated missions, is responsible for coordinating with private-sector stakeholders and aligning Federal and State efforts to eliminate duplication of quality-related initiatives. Primary activities of the IWG will be to National Healthcare Disparities Report, 2011 31
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 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 68 and 69: Effectiveness of Care Chapter 2 Car
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:
Effectiveness of Care Figure 2.25.
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:
Effectiveness of Care Also, in the
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:
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 230 and 231:
Page 232 and 233:
Access to Health Care Financial Bur
Page 234 and 235:
Access to Health Care Chapter 9 n O
Page 236 and 237:
Page 238 and 239:
Priority Populations Chapter 10 232
Page 240 and 241:
Priority Populations AHRQ’s Prior
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:
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?