The 2016 report shows improvement to quality in the United States, but disparities show slow and minimal improvement from 2010 to present day.
Access for the uninsured showed some improvement compared to already insured and while some disparity metrics showed slight improvement, poor and uninsured populations continue to struggle.
Excerpt: “The report is based on more than 250 measures of quality and disparities covering a broad array of health care services and settings. Selected findings in each priority area are shown in this report, as are examples of large disparities, disparities worsening over time, and disparities showing improvement. The report is produced with the help of an Interagency Workgroup led by AHRQ [Agency for Healthcare Research and Quality].”
• “Access: While most access measures (65%) tracked in this report did not demonstrate significant improvement (2000-2014), uninsurance rates (measured as uninsured at the time of interview) decreased from 2010 to 2016.
• Quality: Quality of health care improved overall from 2000 through 2014-2015 but the pace of improvement varied by priority area:
o Person-Centered Care: About 80% of person-centered care measures improved overall.
o Patient Safety: Almost two-thirds of patient safety measures improved overall.
o Healthy Living: About 60% of healthy living measures improved overall.
o Effective Treatment: More than half of effective treatment measures improved overall.
o Care Coordination: About half of care coordination measures improved overall.
o Care Affordability: About 70% of care affordability measures did not change overall.
• Disparities: Overall, some disparities were getting smaller from 2000 through 2014-2015, but disparities persist, especially for poor and uninsured populations in all priority areas:
o While 20% of measures show disparities getting smaller for Blacks and Hispanics, most disparities have not changed significantly for any racial and ethnic groups.
o More than half of measures show that poor and low-income households have worse care than high-income households; for middle-income households, more than 40% of measures show worse care than high-income households.
o Nearly two-thirds of measures show that uninsured people had worse care than privately insured people.”
WBB Take: Although the AHRQ report shows disappointing results on access to care and health disparities, the report reflected welcome news that care quality showed improvement. In terms of the “STEEEPA”* quality model, the report showed significant improvements for patient Safety, Effectiveness of care, and Patient centeredness. This is an important shift, and shows progress towards reducing the high degree of waste, and high levels of morbidity and mortality related to medical error.
However, there was little improvement for Affordability of care, and Equitability of care showed slow and inconsistent improvement. One highly disappointing result related to care coordination. Of 31 care coordination measures, 8 (26%) worsened. Highly effective and efficient care coordination is a foundational component of reducing waste and error, and further overall progress will be hampered without significant improvement in care coordination.
* Safe, Timely, Effective, Efficient, Equitable, Patient-Centered, and Affordable
Cited by Shannen Irwin