miércoles, 12 de marzo de 2014

Trends in Health Care Quality and Disparities for Children Examined in New AHRQ Study

Limited progress was shown in child and adolescent health care quality from 2000 through 2009, and opportunity remains for improvement, according to an abstract of a new AHRQ study in the March/April issue of Academic Pediatrics. The authors of “Child and Adolescent Health Care Quality and Disparities: Are We Making Progress?” identified 39 measures with sufficient data to analyze trends in disparities in quality from AHRQ's 2011 National Healthcare Quality Report and 2011 National Healthcare Disparities Report. They then looked at comparison groups within those measures and found that 126 comparisons showed no change, eight improved and three worsened. For example, trends for asthma care showed no change in disparities in hospital admission rates for four comparison groups (poor, low-income, Black and Hispanic). There was improvement in the daily use of preventive medication by non-Hispanic black children, although rates for those children remained low (just under 18 percent). The authors noted that federal efforts such as the Affordable Care Act and the Children’s Health Insurance Program Reauthorization Act are addressing quality and access to care for children.

2014 Mar-Apr;14(2):137-48. doi: 10.1016/j.acap.2013.11.008.

Child and adolescent health care quality and disparities: are we making progress?

Dougherty D1, Chen X2, Gray DT3, Simon AE4.

Author information

Abstract

OBJECTIVE:

Children and adolescents are known to experience poor health care quality; some groups of children have poorer health care than others. We sought to examine trends over time in health care quality and disparities by race, Hispanic ethnicity, income, insurance, gender, rurality, and special health care needs.

METHODS:

Source data were extracted from the 2011 National Healthcare Quality Report (NHQR) and National Healthcare Disparities Report (NHDR) database, which contains aggregated data from many government and private sources for the years 2000 through 2009. The NHQR and NHDR approaches to calculating disparities and trends in quality and disparities were used. Within each quality measure with available data, results for demographic subgroups of children characterized by race/ethnicity, income, insurance, residence, special health care need, and gender were compared to those of a reference group to determine whether disparities existed and whether disparities had changed over time.

RESULTS:

Of 68 measures with data for calculating potential disparities, 50 showed disparities in quality for at least 1 comparison subgroup in the most recent year of data available, while 18 measures showed no such disparities. Of the 50 measures with current disparities, 39 measures had sufficient data to calculate trends. Among the 137 comparisons made within these 39 measures, there was no change in disparities over time for 126 comparisons, 3 comparisons worsened, and 8 comparisons improved.

CONCLUSIONS:

There was some progress in health care quality and reducing disparities in children's health care quality from 2000 to 2009; opportunities for targeting improvement strategies remain.

Published by Elsevier Inc.