National Healthcare Disparities Report - LDI Health Economist

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Effectiveness of Care Cancer Importance Chapter 2 Cancer Mortality Number of deaths (2011 est.) ...............................................................................................571,950 (ACS, 2011) Cause of death rank (2009 prelim.)..........................................................................2nd (Kochanek, et al., 2011) Prevalence Number of living Americans who have been diagnosed with cancer (2008) .............................................................................................................11,957,599 (Howlader, et al., 2008) Incidence New cases of cancer (2011 est.)........................................................................................1,596,670 (ACS, 2011) New cases of breast cancer (2011 est.)................................................................................232,620 (ACS, 2011) New cases of colorectal cancer (2011 est.)..........................................................................141,210 (ACS, 2011) Cost Total cost i (2010) ....................................................................................................$226.8 billion (NHLBI, 2010) Direct costs ii (2010).................................................................................................$103.8 billion (NHLBI, 2010) Indirect costs (2010)...............................................................................................$161.0 billion (NHLBI, 2010) Cost-effectiveness iii of breast cancer screening.....................$35,000-$165,000/QALY (Maciosek, et al., 2006) Measures Evidence-based consensus defining good quality care and how to measure it currently exists for only a few cancers and a few aspects of care. Breast and colorectal cancers have high incidence rates and are highlighted in alternate years of the National Healthcare Quality Report (NHQR) and National Healthcare Disparities Report (NHDR). In even years, the reports focus on colorectal cancer, and in odd years, the reports focus on breast cancer. This year, the report measures are: i Throughout this report, total cost equals cost of medical care (direct cost) and economic costs of morbidity and mortality (indirect cost). ii Direct costs are defined as “personal health care expenditures for hospital and nursing home care, drugs, home care, and physician and other professional services.” iii Cost-effectiveness is measured here by the average net cost of each quality-adjusted life year (QALY) that is saved by the provision of a particular health intervention. QALYs are a measure of survival adjusted for its value: 1 year in perfect health is equal to 1.0 QALY, while a year in poor health would be something less than 1.0. A lower cost per QALY saved indicates a greater degree of costeffectiveness. 50 National Healthcare Disparities Report, 2011
Effectiveness of Care n Breast cancer screening. n Breast cancer first diagnosed at advanced stage. n Axillary node dissection or sentinel lymph node biopsy at time of surgery for breast cancer. n Radiation therapy following breast-conserving surgery. n Breast cancer deaths. Findings NEW Prevention: Breast Cancer Screening Early detection of cancer allows more treatment options and often improves outcomes. Mammography, the most effective method for detecting breast cancer at its early stages, can identify malignancies before they can be felt and before symptoms develop. Previous reports tracked receipt of mammography among women age 50 and over. The breast cancer screening measure used in the 2011 NHQR and NHDR reflects a more recent recommendation of the U.S. Preventive Services Task Force for mammograms every 2 years for women ages 50-74. Figure 2.1. Women ages 50-74 who reported they had a mammogram within the past 2 years, by race and ethnicity, 2000, 2003, 2005, and 2008 Chapter 2 Cancer 100 White Black Asian 2008 Achievable Benchmark: 88% 100 Total Non-Hispanic White Hispanic 2008 Achievable Benchmark: 88% 75 75 Percent Percent 50 50 25 Z 25 Z 2000 2003 2005 2008 2000 2003 2005 2008 Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2000, 2003, 2005, and 2008. Denominator: Civilian noninstitutionalized women ages 50-74. Note: Rates are age adjusted to the 2000 U.S. standard population. National Healthcare Disparities Report, 2011 51
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NATIONAL HEALTHCARE DISPARITIES REP
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Acknowledgments The NHQR and NHDR a
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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 at admission
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Effectiveness of Care References 20
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Effectiveness of Care Oral health i
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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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Timeliness Findings Getting Care fo
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Timeliness Chapter 4 n Not all pati
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Patient Centeredness Chapter 5 Simi
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Care Coordination Importance Chapte
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Care Coordination n In 2009, Americ
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Efficiency Findings Chapter 7 Inapp
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U.S. Department of Health and Human
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