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Future Directions for the National Healthcare Quality and Disparities Reports Appendix B Key Findings of the NHQRs and NHDRs The Future Directions committee scanned key messages from each year of the NHQR (Table B-1) and the NHDR (Table B-2) to evaluate the content of these messages. Each year’s statements are variations on similar themes: that the quality of health care is suboptimal, that the pace of improvement is slow, and that disparities persist. The committee recommends reformulating the Highlights section of the reports, where such key messages are presented, to be more focused on priority areas, and geared toward future actions. Accordingly, key messages should be more targeted and action-oriented.
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Future Directions for the National Healthcare Quality and Disparities Reports TABLE B-1 Key Findings of the National Healthcare Quality Report from 2003 to 2008, by Year 2003 2004 2005 2006 2007 2008 Greater improvement is possible Quality is improving in many areas, but change takes time Health care quality continues to improve at a modest pace across most measures of quality Most measures of quality are improving, but the pace of change remains modest Health care quality continues to improve, but the rate of improvement has slowed Health care quality measurement is evolving, but much work remains High quality health care is not yet a universal reality The gap between the best possible care and actual care remains large Variation in health care quality remains high Reporting of hospital quality is leading improvement, but patient safety is lagging Health care quality improvement is variable, with notable areas of high performance Variation in quality of health care across the Nation is decreasing, but not for all measures Opportunities for preventive care are frequently missed The rate of improvement accelerated for some measures while a few continued to show deterioration Further improvement in health care is possible Health care quality is suboptimal and continues to improve at a slow pace Management of chronic diseases presents unique quality challenges Health care quality is improving, but more remains to be done to achieve optimal quality The safety of health care has improved since 2000, but more needs to be done There is more to learn Quality improvement varies by setting and phase of care Sustained rates of quality improvement are possible SOURCE: AHRQ, National Healthcare Quality Reports, 2003-2008. TABLE B-2 Key Findings of the National Healthcare Disparities Report from 2003 to 2008, by Year 2003 2004 2005 2006 2007 2008 Inequality in quality persists Disparities are pervasive Disparities still exist Disparities remain prevalent Overall, disparities in health care quality and access are not getting smaller Disparities persist in health care quality Improvement is possible Improvement is possible Some disparities are diminishing Some disparities are diminishing while others are increasing Magnitude and pattern of disparities are different within subpopulations Data limitations hinder targeted improvement efforts Gaps in information exist, especially for specific conditions and populations Progress is being made, but many of the biggest gaps in quality and access have not been reduced Opportunities for improvement remain Opportunities for reducing disparities remain Some disparities exist across multiple priority populations Differential access may lead to disparities in quality Information about disparities is improving Information about disparities is improving, but gaps still exist The problem of persistent uninsurance is a major barrier to reducing disparities Knowledge of why disparities exist is limited Disparities come at a personal and societal price Opportunities to provide preventive care are frequently missed SOURCE: AHRQ, National Healthcare Disparities Reports, 2003-2008.