Spending More and Getting Less

(AHRQ: Rockville, Maryland) -- According to the Agency for Healthcare Research and Quality’s (AHRQ) 2007 National Healthcare Quality Report and National Healthcare Disparities Report, quality improvement rates are lower than the 3.1 percent average annual improvement rate reported in 2006 while health care spending has increased by a 6.7 percent average annual rate over the same period.

“Health care quality is improving only modestly, at best,” says Carolyn M. Clancy, M.D. and AHRQ director. “Given that health care spending is rising much faster, these findings about quality underscore the urgency to improve the value Americans are getting for their health care dollars.”

The 2007 reports draw on data from more than three dozen databases, most sponsored by federal health agencies. This year’s National Healthcare Quality Report synthesizes more than 200 "quality measures," which range from how many pregnant women received prenatal care to what portion of nursing home residents were controlled by physical restraints. Meanwhile, the National Healthcare Disparities Report summarizes which racial, ethnic, or income groups are benefiting from improvements in care and updates national trends in the delivery of health care. The analyses measure quality and disparities in four areas: effectiveness of care, patient safety, timeliness of care, and patient centeredness.

In general, the reports noted that lack of health insurance may have significant effect on health care quality. However, there were some notable gains in the care of heart disease patients and patient safety. The reports also showed some reductions in disparities of care according to race, ethnicity, and income.

For example, while Hispanics are still more likely than whites to get delayed care or no care at all for an illness, that disparity decreased between 2000/2001 and 2004/2005. In addition, while black children between 19 and 35 months old remain less likely than white children to receive all recommended vaccines that disparity also decreased.

Overall, many of the largest disparities remain. Black children under 18 are 3.8 times more likely than white children to be hospitalized for asthma. New AIDS cases are 3.5 times more likely among Hispanics than whites. Among pregnant women, American Indians or Alaska natives are 2.1 times less likely to receive first trimester prenatal care.

For further information regarding this report, visit www.ahrq.gov/news/press/pr2008/qrdr07pr.htm

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