Recently, the Agency for Healthcare Research and Quality (AHRQ) released its annual report on healthcare access, quality, and disparities within the US Healthcare System and included data points on over 200 measures on healthcare process, access, and outcomes from 2001-02 to 2010-11. This report also focused on disparities in healthcare delivery among different racial/ethnic groups and socioeconomic status.
Overall, this report found quality of care to be fair (i.e. 70% of the patient population received recommended care) and varying greatly between different states, with poorer quality of care more distributed in in West South Central and East South Central states. Individuals with low socioeconomic status also received poorer care than those with higher socioeconomic status on 60% of the quality-related measures. However, access was found to have become worse, with 26% of the patient population not having difficulties receiving care (prior to Affordable Care Act implementation). Disparities were found not to have changed during the time period, with fewer gaps in disparities data among major racial groups, but disparities becoming greater in cancer screening and maternal and child health. Gaps in disparities data did remain for Native Hawaiians and Pacific Islanders.
Selected highlights among disparities in healthcare quality between different racial/ethnic groups include:
- Blacks and Latinos received worse care than Whites for about 40% of quality measures.
- There were worsening disparities between Blacks and Whites, with Blacks doing worse on measures related to late-stage breast cancer diagnosis among women aged 40 and older, maternal deaths, and patients aged 40 and older who lived with diabetes and received at least 2 hemoglobin A1C measurements annually.
- There was a worsening disparities between Latinos and Whites, particularly with a smaller proportion of the Latino population experiencing improved mobility among its adult home healthcare patients.
- Asians received worse care than Whites for about one-quarter of quality measures
- There was a worsening disparity between Asians and Whites, with Asian adults aged 18-64 receiving pneumonia-related vaccinations if they are at high risk for chronic obstructive pulmonary disease.
- Native Hawaiians have higher mortality across the lifespan (40% higher compared to Whites).
- American Indians/Alaska Natives received worse care than Whites for approximately one-third of quality measures.
The report‘s authors indicated that the US healthcare system must focus on preventive care and chronic disease management in order to improve access to care and disparities, while also accelerating improvements in healthcare quality. The authors also called for quicker and more efficient dissemination of information and data to all stakeholders in ensuring that patients receive accessible and quality healthcare.
Joanne Chan, Joint Center Graduate Scholar, Harvard School of Public Health