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Quality of care improving, but disparities remain

Quality Improvement Monitor, February 24, 2005

Healthcare quality in the United States has improved, but disparites in care related to race, ethnicity, and economic status still exist, according to two new reports released February 22.

The reports from the Agency for Healthcare Research and Quality (AHRQ) measure quality and disparities in four key areas of health care: effectiveness, patient safety, timeliness, and patient centeredness. They also present data on the quality of and differences in access to services for clinical conditions, including cancer, diabetes, end-stage renal disease, heart disease, and respiratory diseases; and for nursing home and home health care.

The quality report noted

• a decrease of 37% from 2002 to 2003 in the percentage of nursing home patients who have moderate or severe pain
• a decrease of 34% from 1994 to 2001 in the hospital admission rate for uncontrolled diabetes
• a decrease of 34% from 1996 to 2000 in the percentage of elderly patients who were given potentially inappropriate medications

A subset of measures with the comparable data for 2000 and 2001 is highlighted in the 2004 Disparities Report. In both years

• African-Americans received poorer quality of care than whites for about two-thirds of quality measures and had worse access to care than whites for about 40% of access measures
• Asians received poorer quality of care than whites for about 10% of quality measures and had worse access to care than whites for about a third of access measures
• Native Americans and Alaska Natives received poorer quality of care than whites for about a third of quality measures and had worse access to care than whites for about half of access measures

The National Healthcare Quality Report and National Healthcare Disparities Report are available on AHRQ's QualityTools Web site at www.qualitytools.ahrq.gov.

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