Several Fund-sponsored efforts in the past year have sought to gather and disseminate information on quality. A chartbook focusing on the quality of health care services delivered to Medicare beneficiaries—part of a series of Fund chartbooks on quality—presents information distilled from 400 studies on preventive care, treatment of chronic conditions, mental health, and other topics.⁽²⁾ Authors Sheila Leatherman and Douglas McCarthy report on Medicare's successes in ensuring access to needed care and improving the provision of certain preventive services; they also pinpoint areas where the program can improve quality and eliminate health disparities. For example, while the rate of mammograms for women over age 65 has tripled over the past decade, influenza vaccination rates still vary widely by state. In 2003, 80 percent of Medicare enrollees in Minnesota received flu shots, compared with only 60 percent in Nevada.

The Medicare quality chartbook was released at an Alliance for Health Reform briefing in Washington, D.C., that brought together a large group of policy leaders and experts. Leatherman and McCarthy are now working on a series of "quality snapshots," which will be published twice a year, beginning in 2006, to provide up-to-date information on important quality indicators, as well as new data on emerging issues.

While data on the quality of care in health plans have been available for more than a decade, until recently there has not been similar information on the care delivered by hospitals. The Hospital Quality Alliance Program—the first national initiative to report information on hospital performance on a routine basis—was launched in 2003. By the first quarter of 2004, well over 3,168 hospitals had reported on at least one measure of quality. Fund-supported researcher Ashish K. Jha, M.D., and his colleagues were the first to examine these hospital data. Their findings, published in the New England Journal of Medicine,⁽³⁾ reveal that quality of hospital care varies widely by geographic region, type of hospital, and clinical condition. In the next phase of this project, Jha will examine the relationship between hospital quality and cost.