Report at a Glance
Future Directions for the National Healthcare Quality and Disparities Reports
As the United States devotes extensive resources to health care, evaluating how successfully the U.S. system delivers high-quality, high-value care in an equitable manner is essential. The U.S. Congress asked the Agency for Healthcare Research and Quality (AHRQ) to annually produce the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). The reports have revealed areas in which health care performance has improved over time, but they also have identified major shortcomings. The 2008 NHQR found that across the process of care measures tracked in the reports, patients received recommended care less than 60 percent of the time. The NHDR found that even when overall quality of care improves, disparities often persist across socioeconomic groups, racial and ethnic populations, and geographic areas. After five years of producing the NHQR and NHDR, AHRQ asked the Institute of Medicine (IOM) for guidance on how to improve the next generation of reports.
Advancing National Action
The IOM report Future Directions for the National Healthcare Quality and Disparities Reports concludes that the NHQR and NHDR have made important contributions in raising awareness of the state of the nation’s health care and in identifying gaps in quality and equity. Generally, however, the NHQR and the NHDR can be improved in ways that would make them more influential in promoting change in the health care system. In addition to being sources of data on past trends, the national healthcare reports can provide more detailed insights into current performance, establish the value of closing gaps in quality and equity, and project the time required to bridge those gaps at the current pace of improvement.
The IOM report’s authoring committee determined that AHRQ should:
- Align the NHQR and NHDR with nationally recognized priority areas.
- Select measures that reflect health care attributes or processes that are deemed to have the greatest impact on population health.
- Affirm that achieving equity is an essential part of quality improvement.
- Increase the reach and usefulness of AHRQ’s family of report-related products.
- Analyze and present data in ways that will inform policy and promote best-in-class achievement for all actors.
- Identify measure and data needs to set a research and data collection agenda.
To address these points, the IOM report offers a set of national priority areas for quality improvement, provides a more quantitative and transparent method of evaluating measures for inclusion in the reports, and recommends ways to increase understanding of content and to refocus the scope of health care data collected and reported.
While AHRQ can and should consider priority areas in its reports and measure selection, that alone is not enough. The committee concludes that the Secretary of the U.S. Department of Health and Human Services (HHS) is uniquely positioned to adopt national priority areas and set goals, thereby guiding collective efforts by the public and private sectors and bringing the policies and resources of departmental programs to bear on their accomplishment.