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Despite Quality Improvements, Disparities Remain in Health Care, Reports Find

February 22, 2005—Disparities related to race, ethnicity, and socioeconomic status remain in the American health care system but improvements have been made in several areas, including diabetes, mammogram testing, and medication errors, according to two new federal reports.

The Agency for Healthcare Research and Quality (AHRQ), an agency within HHS, on Tuesday released its second annual national reports on the quality of and disparities in health care in America.

The reports measure quality and disparities in effectiveness of care, patient safety, timeliness, and patient centeredness. The reports also present disparities in the quality of access and differences in access to services for clinical conditions such as cancer, diabetes, and nursing home and home health care.

Both studies "provide a benchmark on the quality of care and health disparities in our country, and they also track the progress we are making," said Dr. Carolyn M. Clancy, AHRQ director. "This is important information for those who wish to improve health care quality and access to services for all individuals."

Among its findings, the 2004 National Healthcare Disparities Report concluded that blacks received poorer quality of care than whites for about two-thirds of qualify measures and had worse access to care than whites for about 40 percent of access measures.

Hispanics received lower quality of care than non-Hispanic whites for half of quality measures and had worse access to care than non-Hispanic whites for about 90 percent of access measures.

While disparities are pervasive, improvement is possible but gaps in information exist, especially for specific conditions and populations, the report notes.

One bright spot was the improvement in care provided to the nation's poor, uninsured, and minorities through federally supported health centers.

The 2004 National Healthcare Quality Report finds that while quality is improving in many areas, change takes time. It also notes that the gap between the best possible care and actual care remains large, with the quality of care remaining "highly variable" across the country.

Some of the biggest improvements in care included a 37 percent decrease from 2002 to 2003 in the percentage of nursing home patients who have moderate or severe pain and a 34 percent drop from 1994 to 2001 in the hospital admission rate for uncontrolled diabetes.

The report also noted a 34 decrease from 1996 to 2000 in the percentage of elderly patients who were given potentially inappropriate medications.

Many improvements were also noted at the state level, including Minnesota, which had the largest improvement in state rank for mammogram testing.

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