National Healthcare Disparities Report - LDI Health Economist

More documents

Recommendations

Info

Acknowledgments The NHQR and NHDR are the products of collaboration among agencies across the Department of Health and Human Services (HHS). Many individuals guided and contributed to this report. Without their magnanimous support, this report would not have been possible. Specifically, we thank: Primary AHRQ Staff: Carolyn Clancy, William Munier, Katherine Crosson, Ernest Moy, Karen HoChaves, William Freeman, and Doreen Bonnett. HHS Interagency Workgroup for the NHQR/NHDR: Girma Alemu (HRSA), Hakan Aykan (ASPE), Rachel Ballard-Barbash (NCI), Magda Barini-Garcia (HRSA), Kirsten Beronio (ASPE), Douglas Boenning (ASPE), Julia Bryan (HRSA), Steven Clauser (NCI), Rachel Clement (HRSA), Martin Dannenfelser (ACF), Agnes Davidson (OPHS), Brenda Evelyn (FDA), Susan Fleck (CMS/NC), Edward Garcia (CMS), Miryam Gerdine (HRSA), Olinda Gonzalez (SAMHSA), Tanya Grandison (HRSA), Saadia Greenberg (AoA), Kirk Greenway (IHS), Lein Han (CMS), Linda Harlan (NCI), Rebecca Hines (CDC/NCHS), Edwin Huff (CMS/OA), Meghan Hufstader (ONC), Deloris Hunter (NIH), Memuna Ifedirah (CMS/OCSQ), Kenneth Johnson (OCR), Ruta Kadonoff (ASPE), Ruth Katz (ASPE), Richard Klein (CDC/NCHS), Lisa Koonin (CDC/NCHS), Helen Lamont (ASPE), Shari Ling (CMS/OCSQ), Leopold Luberecki (ASPE), Diane Makuc (CDC/NCHS), Richard McNaney (CMS), Diane Meier (ASPE), Nancy Miller (NIH), Carmen Moten (NIH/NIMH), Iran Naqvi (ORH), Leo Nolan (IHS), Cynthia Ogden (CDC/NCHS), Karen Oliver (NIH/NIMH), Lisa Patton (ASPE), Diane Pilkey (ASPE), Susan Polniaszek (ASPE), Suzanne Proctor-Hallquist (CDC/NCHS), Barry Portnoy (NIH/OD), Michael Rapp (CMS), Georgetta Robinson (CMS), William Rodriguez (FDA/OD), Rochelle Rollins (OMH), Asel Ryskulova (CDC/NCHS), Michael Schoenbaum (NIMH), Adelle Simmons (ASPE), Alan E. Simon (CDC/NCHS), Sunil Sinha (CMS), Jane Sisk (CDC/NCHS), Phillip Smith (IHS), Nancy Sonnenfeld (CDC/NCHS), Caroline Taplin (HHS-ASPE), Emmanuel Taylor (NCI), Wilma Tilson (ASPE), Karmen Todd (OCR), Benedict Truman (CDC), Sayeedha Uddin (CDC/NCHS), Nadarajen A. Vydelingum (NIH), Barbara Wells (NHLBI), Valerie Welsh (OPHS/OMH), Deborah Willis-Fillinger (HRSA), Lee Wilson (ASPE/OS), Susan Yanovski (NIH/NIDDK), and Pierre Yong (ASPE). AHRQ NHQR/NHDR Team: Roxanne Andrews (CDOM), Barbara Barton (SSS), Doreen Bonnett (OCKT), Jeffrey Brady (CQuIPS), Eva Chang (CQuIPS), Xiuhua Chen (SSS), Fran Chevarley (CFACT), Cecilia Rivera Casale (OEREP), Karen Ho Chaves (CQuIPS), Beth Collins Sharp (OEREP), Katherine Crosson (CQuIPS), Denise Dougherty (OEREP), William Freeman (CQuIPS), Erin Grace (CP3), Darryl Gray (CQuIPS), Padmini Jagadish (OEREP), Heather Johnson-Skrivanek (CP3), Ram Khadka (SSS), Shyam Misra (OEREP), Atlang Mompe (SSS), Ernest Moy (CQuIPS), William Munier (CQuIPS), Ryan Mutter (CDOM), Janet Pagán-Sutton (SSS), Amir Razi (SSS), Judy Sangl (CQuIPS), Nancy Wilson (IOD), and Marc Zodet (CFACT). HHS Data Experts: Barbara Altman (CDC/NCHS), Anjani Chandra (CDC/NCHS), Steven Cohen (AHRQ), James Colliver (SAMHSA), Paul Eggers (NIH), David Keer (ED/OSERS), William Mosher (CDC/NCHS), Cynthia Ogden (CDC/NCHS), Robin Remsburg (CDC/NCHS), Asel Ryskulova (CDC/NCHS), Alan E. Simon (CDC/NCHS), Jane Sisk (CDC/NCHS), and members of the Interagency Subcommittee on Disability Statistics. Other Data Experts: Dale Bratzler (Oklahoma QIO), Michael Halpern (NCDB, American Cancer Society), Allen Ma (Oklahoma QIO), Lauren Miller (Oklahoma QIO), Wato Nsa (Oklahoma QIO), Bryan Palis (American College of Surgeons), Florentina R. Salvail (Hawaii Department of Health), Allison Petrilla (NHCPO), Hardy Spoehr (Papa Ola Lokahi), Andrew Stewart (NCDB, American College of Surgeons), Jo Ann Tsark (Papa Ola Lokahi), and Claudia Wright (Oklahoma QIO). Other AHRQ Contributors: Cindy Brach, Karen Fleming-Michael, Christine Heidenrich, Biff LeVee, Corey Mackison, Gerri Michael-Dyer, Karen Migdail, Linwood Norman, Pamela Owens, Mamatha Pancholi, Larry Patton, Wendy Perry, Mary Rolston, Scott Rowe, Bruce Seeman, Randie Siegel, and Phyllis Zucker. Data Support Contractors: CHD-Fu, Social and Scientific Systems, Thomson Reuters Healthcare, and Westat. National Healthcare Disparities Report, 2011
Contents Chapter Page Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1. Introduction and Methods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 2. Effectiveness of Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Cardiovascular Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Chronic Kidney Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 HIV and AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Maternal and Child Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Mental Health and Substance Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Musculoskeletal Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Respiratory Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Lifestyle Modification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 Functional Status Preservation and Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Supportive and Palliative Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 3. Patient Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 4. Timeliness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155 5. Patient Centeredness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 6. Care Coordination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 7. Efficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191 8. Health System Infrastructure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203 9. Access to Health Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 10. Priority Populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233 Appendixes: Data Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . www.ahrq.gov/qual/qrdr11/datasources/index.html Detailed Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . www.ahrq.gov/qual/qrdr11/methods/index.html Measure Specifications . . . . . . . . . . . . . . . . . . . . . . www.ahrq.gov/qual/qrdr11/measurespec/index.html Data Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . www.ahrq.gov/qual/qrdr11/index.html National Healthcare Disparities Report, 2011
Page 1: NATIONAL HEALTHCARE DISPARITIES REP
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:
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

Create successful ePaper yourself

Delete template?

Save as template?