National Healthcare Disparities Report - LDI Health Economist

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Introduction and Methods Progress on individual measures was determined as follows: n Progress on a measure is deemed to be improving if the average annual rate of change is 1% or greater in the desirable direction, and p
Introduction and Methods From an equity perspective, standards of performance should not differ across population groups. As such, benchmarks corresponding to measures included in both the NHQR and NHDR were identical. Benchmarks were estimated for the subset of measures for which State data were available. Values of benchmarks estimated in 2010 have been carried over to the 2011 reports. For measures for which State-level data were available, benchmarks were estimated as the average value for the 10% of States that had the best performance on the measure of interest. For benchmarking purposes, the District of Columbia is treated as a State. Benchmarks were estimated only if data were available for a minimum of 30 States. Identical benchmarks were used to characterize performance in both the NHDR and NHQR. State-level estimates used in constructing benchmarks were primarily calculated from the same data source as the measure. In some cases, such as when the number of individuals sampled from a specific State was too small, data did not support estimation at a subnational level and benchmarks were not identified. We made exceptions for three measures derived from the Medical Expenditure Panel Survey (MEPS) and the National Health Interview Survey (NHIS). Chapter 1 For these measures of colorectal cancer screening, diabetes care, and pneumococcal vaccination, almost identical data were available from Behavioral Risk Factor Surveillance System (BRFSS) State data. However, BRFSS sampling and mode of administration differ from MEPS and NHIS. Hence, to calculate a benchmark for these measures, we first calculated the ratio of the top 10% achievable benchmark to the overall national estimate from BRFSS. We then applied this ratio to the overall national estimate from MEPS or NHIS. For example, if the BRFSS benchmark to national estimate ratio for a measure was 1.5, we would multiply the national estimate for that measure from MEPS by 1.5 to obtain a corresponding benchmark. Time To Achieve Benchmark Projections of the time expected for population subgroups to achieve the designated benchmark based on past performance are again included in the 2011 reports. Using standard linear regression of the actual values over time and extrapolating to future years, we calculated the time required for the population, or population subgroup, to perform at the level of the top-performing States. Since projections of future performance were based on past performance data, we needed to ensure reliability by limiting estimates to those cases in which at least four data points were available. An important caveat to consider in using information on time to achieve benchmarks is that the linear estimation approach used to derive these estimates assumes that characteristics of the population, technology, and health care infrastructure remain constant. Changes in the characteristics of the population or health care system may be expected to alter achievement of benchmarks. Advancements in medical science, changes in the organization of health services, or reductions in the uninsured population following implementation of the Patient Protection and Affordable Care Act (P.L. 11-148) would be expected to alter the performance trajectory. In some cases, the time to achieve the benchmark will drop, while in other cases it may increase. Time to achieve a benchmark is not presented for measures that met one or more of the following conditions: n Average annual rate of change is less than 1%. n Time to benchmark is estimated at 25 or more years. National Healthcare Disparities Report, 2011 45
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 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 96 and 97: Effectiveness of Care Prevention: W
Page 98 and 99: Effectiveness of Care Mental Health
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Effectiveness of Care Figure 2.31.
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Effectiveness of Care NEW Musculosk
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Effectiveness of Care n In all year
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Effectiveness of Care NEW Managemen
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Effectiveness of Care Findings Prev
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Effectiveness of Care Also, in the
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Effectiveness of Care Chapter 2 Res
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Effectiveness of Care Lifestyle Mod
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Effectiveness of Care n In 5 out of
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Effectiveness of Care NEW Outcome:
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Effectiveness of Care Chapter 2 Lif
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Effectiveness of Care Functional St
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Effectiveness of Care Chapter 2 Fun
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Effectiveness of Care at admission
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Effectiveness of Care Supportive an
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Effectiveness of Care n The 2008 to
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Effectiveness of Care Chapter 2 Sup
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Effectiveness of Care References 20
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Effectiveness of Care Centers for M
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Effectiveness of Care Oral health i
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140 National Healthcare Disparities
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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 Safety Also, in the NHQR: n
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Patient Safety n From 2006-2007 to
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Patient Safety n From 2004 to 2008,
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Patient Safety Chapter 3 n From 200
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Timeliness Findings Getting Care fo
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Timeliness Chapter 4 n Not all pati
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Timeliness Chapter 4 n Among heart
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Patient Centeredness Chapter 5 Simi
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Patient Centeredness Figure 5.1. Ad
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Patient Centeredness Figure 5.3. Ch
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Patient Centeredness Figure 5.5. Ad
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Patient Centeredness Patient Langua
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Patient Centeredness Information ab
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Patient Centeredness Providers Aski
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178 National Healthcare Quality Rep
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Care Coordination Importance Chapte
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Care Coordination n In 2009, Americ
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Care Coordination Figure 6.3. Paren
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Care Coordination Also, in the NHQR
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Care Coordination Chapter 6 n Overa
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Care Coordination Chapter 6 n Overa
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Efficiency Findings Chapter 7 Inapp
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Efficiency Figure 7.2. Potentially
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Efficiency Comparisons with the 3 S
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Efficiency Perforated Appendixes Pe
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Efficiency Figure 7.8. Males age 75
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Health System Infrastructure Eviden
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Health System Infrastructure Figure
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Health System Infrastructure Figure
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Health System Infrastructure Occupa
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Health System Infrastructure n From
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Health System Infrastructure NEW Co
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Health System Infrastructure Table
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Health System Infrastructure Refere
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Access to Health Care Findings Heal
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Access to Health Care Figure 9.2. P
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Access to Health Care Financial Bur
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Access to Health Care Chapter 9 n O
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Priority Populations Chapter 10 232
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Priority Populations AHRQ’s Prior
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Priority Populations Blacks or Afri
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Priority Populations Hispanics or L
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Priority Populations Geographic are
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Priority Populations criminal justi
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Priority Populations Postponement R
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Priority Populations References Adl
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U.S. Department of Health and Human
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