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. At the request of Congress, the Agency for Healthcare Research and Quality (AHRQ) annually produces 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. After five years of producing the NHQR and NHDR, AHRQ asked the IOM for guidance on how to improve the next generation of reports.
The IOM concludes that the NHQR and 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 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.
With these changes, the restructured reports are natural vehicles for tracking the effects of health insurance reform and providing a vision for national quality improvement and disparities elimination. While the NHQR and NHDR alone will not improve the quality of health care in the United States, they can provide compelling information that identifies gaps in care, describes the progress of the nation in closing those gaps, sets a direction for collective investments and action, and identifies evidence-based policies and practices that can assist in achieving better quality care and promoting equity.