Boosting Health Care Quality

Walk into many stores and you’re bound to be impressed by the quality of digital cameras, TVs, cell phones, and other consumer electronics. Every year the quality of these devices improves by leaps and bounds, and consumers often pay less as products improve.

I wish the same could be said about the quality of the health care in America. A new report from the Agency for Healthcare Research and Quality (AHRQ), found that we—patients, doctors, hospitals, nursing homes, health insurers, and others—are taking only baby steps when it comes to making health care safer and more effective.

The agency’s 2007 “National Healthcare Quality Report” found that overall quality improved by an average of 1.5 percent per year between 2000 and 2005. This shows that the quality of health care—which ranges from treating diabetes to protecting patients from medical errors—is just not improving fast enough.

A sister report, the 2007 “National Healthcare Disparities Report,” also shows what many of us already know: Poor Americans and minorities often receive lower quality care. This can happen when people don’t have health insurance. Because they don’t have regular doctors or get needed tests, by the time they get treatment, their medical conditions may have gotten much worse.

Here are some other important facts from both reports:

• Only 70 percent of low-income people have health insurance, compared with 94 percent of high-income people. While 10 percent of Caucasians under 65 didn’t have insurance for all of 2004, this figure was 28 percent for Hispanics, 15 percent for blacks, and 12 percent for Asians.
• People without insurance were less likely to get recommended care. For example, 74 percent of women with private insurance received mammograms in the past two years compared with 38 percent of uninsured women. Fifty-one percent of people with private insurance went to the dentist at least once in the previous year compared to 18 percent of people without insurance.
• The health care system is getting safer, but it’s improving at a rate of only about 1 percent a year. This estimate comes from looking at many safety issues, such as how many older patients were prescribed medicines that might be harmful or how many patients developed problems after surgery.

The reports found some good news, too. For example, in 2005 more than 93 percent of heart attack patients received recommended care in the hospital. The percent of heart attack patients who were advised on how to quit smoking went up to 91 percent in 2005.

As a doctor, I know that improvements in high-tech gadgets aren’t the same as those in health care. Changing our health system involves millions of people working together. Improving quality takes education, a willingness to admit mistakes, and teamwork.

That’s where you, as an involved patient, play an important role. AHRQ offers resources, such as how to be an active health care consumer, that can help you learn what questions to ask. Working with your doctor is an important way to become part of your health care team and can help improve the quality of your care.

There’s a lot of work to do to make health care better. We need you to be involved and to help bring about the improvements in health care we are all seeking.

About the author
Carolyn Clancy, M.D., a general internist and researcher, is an expert in engaging consumers in their health care. She is the director of the Agency for Healthcare Research and Quality.

About The Author