New Reports Show
Weak Progress on Health Quality
By Carolyn M.
Clancy, M.D.
June 2, 2009
If you get sick
or have surgery, you have only a 3 in 5 chance
of getting the care that’s recommended for you.
This statement is so shocking that I wouldn’t
blame you for questioning it.
We have one of
the most advanced health care systems in the
world, with thousands of dedicated doctors and
nurses and many state-of-the-art hospitals. We
know that errors happen and that not everyone
gets access to health care when they need it.
Still, we expect that when we seek out care,
we’ll get the right care.
I wish that were
consistently true. The fact is that U.S.
patients receive the recommended care for their
illness or condition only about 60 percent of
the time, according to a set of
new reports from my agency, the Agency for
Healthcare Research and Quality (AHRQ).
The reports also
show that patient safety actually is getting
worse. For example, 1 in 7 hospitalized Medicare
patients experiences significant harm when
hospitalized, and poor, less educated and
minority Americans tend to receive poorer
quality of care than whites.
These reports
also show that:
- Only 40
percent of patients with diabetes got the
three recommended preventive exams in the
past year, a rate that has stayed the same
over time.
- Only half of
obese adults and children were advised to
exercise more and eat a healthy diet.
- Seven out of
10 adults with mood, anxiety, or impulse
disorders got inadequate treatment or no
treatment at all.
- Blood
infections caused by catheters affect
thousands of hospitalized patients each
year.
We’ve been
publishing these reports every year since 2003.
I’m sorry to report that quality is improving at
a very slow pace. The annual rate of improvement
shown in this year’s report is 1.8 percent. This
is better than last year, but the pace of
progress is not rapid enough to close the major
gaps in quality that we’ve known about for well
over a decade.
As a physician
and as a patient, I want to see faster progress.
And you should, too. We have a right to expect
safer, higher quality health care.
Many health care
organizations are working diligently to improve
quality and safety. But change comes slowly, and
improvements can be hard to sustain. In the
meantime, there are things you can do as a
patient to make sure you get safe, high-quality
care.
The first is to
ask a lot of questions. When it comes to your
health care,
questions are the answer. Engaging your
doctor or nurse in a discussion about your
condition and your care will make sure that
everyone’s paying attention. Simple
questions - "Which hospital is best for my needs?"
and "Will this medicine interact with medicines
I’m already taking?" - will spark a dialogue that
will help you understand your condition and
choose your options.
The second thing
you can do is to conduct your own research about
your hospital or your condition. Medicare’s
Hospital Compare Web tool offers information
on how your local hospitals perform when
treating certain conditions, such as heart
attack or pneumonia, and on other measures,
including patients’ experiences in the hospital.
Many States offer
some type of hospital rating system or tools so
you can get a sense of the quality of care a
hospital provides before you walk in the door.
Check with your State’s insurance department or
health department to find out what tools are
available.
Finally, taking
good care of yourself and getting the right
preventive tests, like being screened for breast
cancer or colorectal cancer, can increase your
chances for staying healthy or catching problems
early when they can be treated more effectively.
It’s also important to maintain your health by
staying at a healthy weight, eating nutritious
foods, and stopping smoking.
AHRQ’s reports
indicate that quality is slowly getting better,
but we still have a long way to go. Health care
organizations and care providers have major
roles to play in improving quality and closing
gaps in care access. You can help by asking
questions, doing your own research, and taking
an active role in maintaining your health.
I’m Dr. Carolyn
Clancy, and that’s my advice on how to navigate
the health care system.
More Information
Agency
for Healthcare Research and Quality
2008 National Healthcare Quality and
Disparities Reports
http://www.ahrq.gov/qual/qrdr08.htm
Agency
for Healthcare Research and Quality
Questions are the Answer
http://www.ahrq.gov/questionsaretheanswer/
Centers
for Medicare & Medicaid Services
Hospital Compare
http://www.hospitalcompare.hhs.gov
Current as of June 2009
Internet Citation:
New Reports Show Weak Progress on Health
Quality. Navigating the Health Care System:
Advice Columns from Dr. Carolyn Clancy, June 2,
2009. Agency for Healthcare Research and
Quality, Rockville, MD. http://www.ahrq.gov/consumer/cc/cc060209.htm
|