Quality of Care, Patient Safety Improving, but Disparities Remain

Improvements in quality of care and patient safety in hospitals have saved $12 billion from 2011-2013, according to a new report from the Agency for Healthcare Research and Quality (AHRQ). Most data included in the report preceded the implementation of a majority of the health insurance expansions included in the Affordable Care Act.

The 2014 National Healthcare Quality and Disparities Report found that there was 17% fewer harms to patients, 1.3 million fewer hospital-acquired conditions, and 50,000 fewer deaths occurred in 2013 compared with 2010. Despite these improvements, AHRQ reported only 70% of recommended care is being delivered across a broad array of quality measures.

“After years of stagnation, rates of uninsurance among adults decreased in the first half of 2014 as a result of Affordable Care Act insurance expansion,” the authors wrote in the report. “However, disparities in access to care, while diminishing, remained.”

The report also found that publicly reported CMS measures were much more likely to achieve high levels of performance compared with measures reported by other sources. Of the 11 measures quality measures that achieved an overall performance level of 95% or better in the 2014 report, 7 were CMS measures.

Some disparities for services such as childhood vaccinations have been reduced to zero, but significant disparities still remained through 2012. People in poor households had worse access to care than people in high-income households on all access measures.

Blacks had worse access than whites for about half of the measures; Hispanics had worse access than whites for two-thirds of measures; and Asians, American Indians, and Alaska Natives had worse access to care than whites for about one-third of access measures.

“Through 2012, most disparities in access to care related to race, ethnicity, or income showed no significant change…” according to the report.

Disparities in quality measures remained prevalent, according to the report. People in poor household experienced the larges number of disparities, followed by blacks and Hispanics. Through 2012, most quality of care disparities showed no significant change.