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Preventive Care Gets Low Marks on AHRQ Quality Report Card

By John Reichard, CQ HealthBeat Editor

January 17, 2007 -- Although quality of care improved overall, preventive care got low marks in 2006 on the annual quality-of-care report card issued by the Agency for Healthcare Research and Quality (AHRQ).

Only about half of Americans got recommended preventive care on four measures of that type of treatment, resulting in billions of dollars of extra care costs, according to the report. In another annual AHRQ snapshot assessing health care disparities in the United States, the agency found that blacks received lower quality of care than whites on 73 percent of the measures of quality of care it evaluated. The agency is required by Congress to issue both reports annually.

"Much more can be done to prevent illness from occurring," AHRQ Director Carolyn M. Clancy said of the latest quality-of-care findings, which included the following:

  • Only 52 percent of adults reported receiving recommended colorectal cancer screenings. About 56,000 Americans die from that type of cancer each year, and 150,000 new cases are diagnosed annually.
  • Fewer than half of obese adults reported being counseled about diet by a health professional, even though obesity increases the risk of high blood pressure, type 2 diabetes, stroke, heart disease, and osteoarthritis.
  • Only 49 percent of people with asthma were told how to change their environment to lessen complications of the disease and just 28 percent reported receiving an asthma management plan. Asthma causes 500,000 hospitalizations annually, AHRQ said.
  • Only 48 percent of adults with diabetes reported receiving all three recommended screenings—those for blood sugar, foot exams, and eye exams—to prevent complications of the disease.

The annual report card based its assessment of the quality of U.S. health care by reviewing the nation's performance on 40 performance measures. It found that the greatest quality gains occurred in hospitals, in part because of improved treatment for heart attack patients and pneumonia patients and steps taken to avoid surgical complications. Those gains stemmed in large part from public reporting on quality-of-care measures used by the Centers for Medicare and Medicaid Services and from activities by "QIOs"—or quality improvement organizations—that contract to improve treatment in Medicare.

The disparities report card found that Hispanics received lower quality of care than non-Hispanic whites for 77 percent of the measures assessed, and that "poor people received lower quality of care than high-income people for 71 percent of the measures." "Variations were particularly apparent in the area of prevention," the agency said.

Obese blacks were less likely to be told they were overweight by their doctor or other health care providers, AHRQ said. "Colorectal cancer screening rates were significantly lower for blacks and Asians when compared with whites," the agency said. "Among people 65 and older, blacks, Hispanics and those in lower income groups were less likely to have ever received a vaccine to prevent pneumonia."

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