National Healthcare Disparities Report - LDI Health Economist

More documents

Recommendations

Info

Effectiveness of Care Also, in the NHQR: n From 1998 to 2008, adults ages 45-64 and age 65 and over were more likely to have a blood cholesterol measurement than adults ages 18-44. Among adults under age 65, those who had public insurance or who were uninsured were less likely to have a blood cholesterol measurement than those with private health insurance. Chapter 2 Cardiovascular Disease NEW Outcome: Inpatient Deaths Following Heart Attack Heart attack, or acute myocardial infarction, is a common life-threatening condition that requires rapid recognition and efficient treatment in a hospital to reduce the risk of serious heart damage and death. Measuring processes of heart attack care can provide information about whether a patient received specific needed services, but these processes make up a very small proportion of all the care that a heart attack patient needs. Measuring outcomes of heart attack care, such as mortality, can provide a more global assessment of all the care a patient receives and usually is the aspect of quality that matters most to patients. Significant improvements in process measures of quality of care for heart attack have occurred in recent years. All process measures tracked in past reports have attained overall performance levels exceeding 95% and have been retired. Therefore, the 2011 NHQR and NHDR focus on outcome measures. Survival following admission for heart attack reflects multiple patient factors, such as a patient’s comorbidities, as well as health care system factors, such as the possible need to transfer patients to other hospitals for services. It also may partly reflect receipt of appropriate health services. Previous reports used AHRQ Quality Indicators version 3.1 to generate death rates for heart attack. The 2011 reports use a modified version 4.1 of the software. While the effects of version change are extremely small, these estimates should not be compared with estimates in previous reports. 60 National Healthcare Disparities Report, 2011
Effectiveness of Care Figure 2.7. Inpatient deaths per 1,000 adult hospital admissions with heart attack, by race/ethnicity and area income, 2001-2008 120 White Black Hispanic API 120 Q1 (Lowest) Q2 Q3 Q4 (Highest) 100 100 Deaths per 1,000 Admissions 80 60 40 20 0 2008 Achievable Benchmark: 47 2001 2002 2003 2004 2005 2006 2007 2008 Key: API = Asian or Pacific Islander; Q1 represents the lowest income quartile and Q4 represents the highest income quartile based on the median income of a patient’s ZIP Code of residence. Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, State Inpatient Databases disparities analysis file, and AHRQ Quality Indicators modified version 4.1, 2001-2008. Denominator: Adults age 18 and over admitted to a non-Federal community hospital in the United States with acute myocardial infarction as principal discharge diagnosis. Note: For this measure, lower rates are better. Rates are adjusted by age and all payer refined-diagnosis related group scoring of risk of mortality. White, Black, and API groups are non-Hispanic; Hispanic includes all races. Deaths per 1,000 Admissions 80 60 40 20 0 2008 Achievable Benchmark: 47 2001 2002 2003 2004 2005 2006 2007 2008 Chapter 2 Cardiovascular Disease n From 2001 to 2008, the overall inpatient mortality rate for hospital admissions with heart attack decreased significantly (data not shown) and for each racial/ethnic and area income group (Figure 2.7). n In all years, Blacks had lower inpatient mortality rates than Whites. n In all years, residents of the two lowest income quartiles had higher inpatient mortality rates than residents of the highest income quartile. n The 2008 top 3 State achievable benchmark for inpatient heart attack mortality was 47 per 1,000 admissions. ix At current rates of improvement, all racial/ethnic and area income groups would attain the benchmark within the next 4 years. Also, in the NHQR: n In all years, patients ages 45-64 and 65 and over had higher rates of inpatient heart attack deaths than patients ages 18-44. Residents of small metropolitan, micropolitan, and noncore (rural) areas had higher rates of inpatient heart attack mortality than residents of large fringe metropolitan areas. ix The top 3 States that contributed to the achievable benchmark are Arizona, Michigan, and Ohio. National Healthcare Disparities Report, 2011 61
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 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 96 and 97: Effectiveness of Care Prevention: W
Page 98 and 99: Effectiveness of Care Mental Health
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 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:
Effectiveness of Care Figure 2.49.
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:
Effectiveness of Care Figure 2.58.
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?