Kelley Ed, Moy Ernest, Stryer Daniel, Burstin Helen, Clancy Carolyn
Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, MD 20850, USA.
Med Care. 2005 Mar;43(3 Suppl):I3-8. doi: 10.1097/00005650-200503001-00002.
Congress directed the Agency for Healthcare Research and Quality (AHRQ) to lead an effort for the US Department of Health and Human Services (DHHS) to develop 2 annual reports: a National Healthcare Quality Report (NHQR) and a National Healthcare Disparities Report (NHDR).
This article lays out key concepts, definitions, statistical methods, and findings from these first ever national reports on quality and disparities. We also summarize some possible future directions for the reports.
The NHQR and NHDR rely on secondary analysis of available data from over 40 established, national databases. The NHQR presents data at the national level, by sociodemographic characteristics, and at the state level. The NHDR presents data broken out by race/ethnicity and by socioeconomic status.
The 2003 NHQR presented data on approximately 140 quality measures and the NHDR presented data on these same measures plus approximately 100 measures of access to care.
The reports found that high healthcare quality is not a given and that disparities are pervasive throughout the US healthcare system. In addition, they found the quality and disparities issues are particularly apparent in preventive care, but that greater improvement is possible.
As these reports evolve for the 2004 version and beyond, they will be a vital step in the effort to improve healthcare quality for all populations in the United States.
国会指示医疗保健研究与质量局(AHRQ)牵头为美国卫生与公众服务部(DHHS)开展一项工作,以编制两份年度报告:一份《国家医疗保健质量报告》(NHQR)和一份《国家医疗保健差异报告》(NHDR)。
本文阐述了这些有史以来第一份关于质量和差异的国家报告中的关键概念、定义、统计方法和研究结果。我们还总结了这些报告未来可能的一些方向。
NHQR和NHDR依赖于对40多个已建立的国家数据库中的现有数据进行二次分析。NHQR在国家层面、按社会人口统计学特征以及在州层面呈现数据。NHDR按种族/族裔和社会经济地位分类呈现数据。
2003年的NHQR呈现了约140项质量指标的数据,NHDR呈现了这些相同指标以及约100项医疗服务可及性指标的数据。
报告发现,高质量的医疗保健并非必然可得,差异在美国医疗保健系统中普遍存在。此外,他们发现质量和差异问题在预防保健中尤为明显,但仍有更大的改进空间。
随着这些报告向2004年及以后版本的演进,它们将成为努力改善美国所有人群医疗保健质量的关键一步。