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Reform to target persistent health disparities.

The quality of health care in the United States Health care in the United States is provided by many separate legal entities. The U.S. spends more on health care, both as a proportion of gross domestic product (GDP) and on a per-capita basis, than any other nation in the world. Current estimates put U.S.  is improving slowly, with the slowest progress occurring in prevention and chronic disease management, according to the latest government data.

The country also continues to struggle with health care disparities. Despite efforts to improve access and quality of care for minorities, new national data show that, overall, minorities and low-income individuals receive the worst health care.

The findings were detailed in two reports released recently by the Health and Human Services department The Department of Health and Human Services (HHS) is the cabinet-level department of the Executive Branch of the federal government most involved with the health, safety, and welfare of the U.S. population. .

The 2009 National Healthcare Quality Report provides a snapshot of how the country is performing on 169 quality measures; the National Healthcare Disparities Report provides a summary of health care quality and access among various racial and ethnic groups, and across income groups.

Although the two reports show significant gaps in care, HHS HHS Department of Health and Human Services.  Secretary Kathleen Sebelius said she expects to see improvement with the implementation of the new health care reform laws--the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act.

"While the Affordable Care Act isn't a cure, we think it's one of the most effective treatments we've had for these problems in a long time," Ms. Sebelius said during a news conference to release the reports.

Specifically, the health care reform laws will expand data collection and research efforts on health care disparities, increase the size and diversity of the health care workforce, and establish a new national institute on minority health and health disparities at the National Institutes of Health. But most importantly, the laws will expand coverage for millions of Americans who are currently uninsured, Ms. Sebelius said.

"In almost every case, populations who are currently underserved get relief [under the new laws], whether it's minority Americans, women, early retirees, rural Americans, or Americans with disabilities," she said.

The 2009 quality report showed that overall quality is improving at a rate of about 2.3% annually. However, the speed of improvement varied across settings of care: Hospitals are improving more rapidly, at a median rate of change of about 5.8%, whereas outpatient settings improved at a median rate of change about 1.4%, according to the report.

As a result, improvements in prevention and chronic disease management are lagging behind improvements in acute care. For example, of the nine process measures tracked in the report that worsened, eight related to either preventive services or chronic disease management, including mammography mammography, diagnostic procedure that uses low-dose X rays to detect abnormalities in the breasts. The early diagnosis of breast cancer made possible by the routine use of mammography for screening women increases a woman's treatment alternatives and improves her , Pap testing, and fecal occult blood Fecal occult blood is a term for blood present in the feces that is not visibly apparent. In medicine, a fecal occult blood test is a check for hidden (occult) blood in the stool (feces). Conventional fecal occult blood tests look for heme.  testing.

"Although the trend is going in the right direction, which is good, the pace is unacceptably slow," said Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality Agency for Healthcare Research and Quality,
n.pr formerly known as the Agency for Health Care Policy and Research, this agency researches the quality of medical care and health services.
, which produced the reports.

On the disparities side, the report showed that many disparities have not decreased over time. For example, from 2000 to 2005, disparities in colorectal cancer screening have grown between American Indians and Alaska Natives vs. whites, increasing at a rate of 7.7% per year. Additionally, blacks and Hispanics had worsening disparities in colorectal cancer mortality from 2000 to 2006.

The two reports are available online at www.ahrq.gov/qual/qrdr09.htm.
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Author:Schneider, Mary Ellen
Publication:Clinical Psychiatry News
Article Type:Clinical report
Date:May 1, 2010
Words:514
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