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2012 National Healthcare Quality Report

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2012 National Healthcare Quality Report Tenth Anniversary 2012 NATIONAL HEALTHCARE QUALITY REPORT Agency for Healthcare Research and Quality Advancing Excellence in Health Care www.ahrq.govNational Healthcare Quality Report, 2012 2012 NATIONAL HEALTHCARE QUALITY REPORT U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality 540 Gaither Road Rockville, MD 20850 AHRQ Publication No. 13-0002 May 2013 www.ahrq.gov/research/findings/nhqrdr/index.html ACKNOWLEDGMENTS The NHQR and NHDR are the products of collaboration among agencies across the Department of Health and Human Services (HHS). Many individuals guided and contributed to these reports. Without their magnanimous support, the reports would not have been possible. Specifically, we thank: Primary AHRQ Staff: Carolyn Clancy, William Munier, Jeffrey Brady, Ernest Moy, Karen Chaves, William Freeman, and Doreen Bonnett. HHS Interagency Workgroup for the NHQR/NHDR: Girma Alemu (HRSA), Chisara Asomugha (CMS), Hakan Aykan (ASPE), Rachel Ballard-Barbash (NCI), Kirsten Beronio (ASPE), Douglas Boenning (ASPE), Julia Bryan (HRSA), Steven Clauser (NCI), Miya Cain (ACF). Susan Fleck (CMS-NC), Edward Garcia (CMS), Miryam Gerdine (HRSA), Olinda Gonzalez (SAMHSA), Tanya Grandison (HRSA), Kirk Greenway (IHS), Lein Han (CMS), Linda Harlan (NCI), Benjamin Hernandez-Stern (OCR), Rebecca Hines (CDC-NCHS), Edwin Huff (CMS-OA), Meghan Hufstader (ONC), Deloris Hunter (NIH), Memuna Ifedirah (CMS-OCSQ), Cara James (CMS), Kenneth Johnson (OCR), Ruth Katz (ASPE), Richard Klein (CDC- NCHS), Michael Kogan (HRSA), Lisa Koonin (CDC-NCHS), Harriet Komisar (ASPE), Helen Lamont (ASPE), Shari Ling (CMS-OCSQ), Quyen Ngo-Metzger (HRSA), Darlene Marcoe (ACF), Karen McDonnell (CMS), Richard McNaney (CMS), Nancy Miller (NIH), Karen Nakano (CMS), Iran Naqvi (HRSA), Leo Nolan (IHS), Cynthia Ogden (CDC-NCHS), Karen Oliver (NIH-NIMH), Lisa Patton (ASPE), Diane Pilkey (ASPE), Suzanne Proctor-Hallquist (CDC-NCHS), Barry Portnoy (NIH-OD), Michael Rapp (CMS), William Rodriguez (FDA- OD), Rochelle Rollins (ACF), Asel Ryskulova (CDC-NCHS), Michael Schoenbaum (NIMH), Adelle Simmons (ASPE), Alan E. Simon (CDC-NCHS), Marsha Smith (CMS), Phillip Smith (IHS), Nancy Sonnenfeld (CMS), Caroline Taplin (ASPE), Emmanuel Taylor (NCI), Karmen Todd (OCR), Benedict Truman (CDC), Sayeedha Uddin (CDC-NCHS), Nadarajen A. Vydelingum (NIH), Barbara Wells (NHLBI), Valerie Welsh (OPHS-OMH), Deborah Willis-Fillinger (HRSA), and Susan Yanovski (NIH-NIDDK). AHRQ NHQR/NHDR Team: Roxanne Andrews (CDOM), Barbara Barton (SSS), Doreen Bonnett (OCKT), Cecilia Casale (OEREP), Eva Chang (CQuIPS), Xiuhua Chen (SSS), Fran Chevarley (CFACT), Karen Chaves (CQuIPS), Monique Cohen (CQuIPS), Beth Collins-Sharp (OEREP), Katherine Crosson (CQuIPS), Denise Dougherty (OEREP), Noel Eldridge (CQuIPS), William Freeman (CQuIPS), Erin Grace (CP3), Darryl Gray (CQuIPS), Leif Karell (SSS), Ram Khadka (SSS), Virginia Kotzias (CQuIPS), Anil Koninty (SSS), Tri Le (CQuIPS), Atlang Mompe (SSS), Ernest Moy (CQuIPS), William Munier (CQuIPS), Ryan Mutter (CDOM), Thomas Otterson (SSS), Janet Pagán-Sutton (SSS), Amir Razi (SSS), Krystle Seu (CQuIPS), Judy Sangl (CQuIPS), Nancy Wilson (IOD), Sean Yin (SSS), and Marc Zodet (CFACT). HHS Data Experts: Clarice Brown (CDC-NCHS), Anjani Chandra (CDC-NCHS), Robin Cohen (CDC- NCHS), Steven Cohen (AHRQ), James Colliver (SAMHSA), Paul Eggers (NIH), David Keer (ED-OSERS), William Mosher (CDC-NCHS), Cynthia Ogden (CDC-NCHS), Asel Ryskulova (CDC-NCHS), and Alan E. Simon (CDC-NCHS). Other Data Experts: Dana Auden (Oklahoma QIO), Michael Halpern (American Cancer Society), Allen Ma (Oklahoma QIO), Wato Nsa (Oklahoma QIO), Bryan Palis (NCBD, American College of Surgeons), Florentina R. Salvail (Hawaii Department of Health), Allison Petrilla (NHCPO), Hardy Spoehr (Papa Ola Lokahi), Andrew Stewart (NCDB, American College of Surgeons), Scott Stewart (Oklahoma QIO), Jo Ann Tsark (Papa Ola Lokahi), and Claudia Wright (Oklahoma QIO). Other AHRQ Contributors: Cindy Brach, Mike Bykowski, Farah Englert, Heather Johnson-Skrivanek , Janet Howard, Biff LeVee, Iris Mabry-Hernandez , Edwin Lomotan, Gerri Michael-Dyer, Karen Migdail, James Kirby, Pamela Owens, Shyam Misra, Linwood Norman, Mamatha Pancholi, Larry Patton, Wendy Perry, Richard Ricciardi, Mary Rolston, Scott Rowe, Randie Siegel, and Phyllis Zucker. Data Support Contractors: CHD-Fu, Social and Scientific Systems, Truven Health Analytics, and Westat. CONTENTS Chapter ..................................................................................................................................................... Page Highlights ....................................................................................................................................................... 1 1. Introduction and Methods ................................................................................................................... 21 2. Effectiveness of Care ........................................................................................................................... 35 Cancer ................................................................................................................................................. 37 Cardiovascular Disease ....................................................................................................................... 45 Chronic Kidney Disease ..................................................................................................................... 52 Diabetes .............................................................................................................................................. 57 HIV and AIDS ....................................................................................................................................... 63 Maternal and Child Health ................................................................................................................... 70 Mental Health and Substance Abuse .................................................................................................. 77 Musculoskeletal Diseases ................................................................................................................... 83 Respiratory Diseases ........................................................................................................................... 87 Lifestyle Modification ........................................................................................................................... 95 Functional Status Preservation and Rehabilitation ............................................................................. 108 Supportive and Palliative Care ............................................................................................................114 3. Patient Safety ......................................................................................................................................127 4. Timeliness ........................................................................................................................................... 143 5. Patient Centeredness .........................................................................................................................151 6. Care Coordination .............................................................................................................................. 163 7. Efficiency .............................................................................................................................................173 8. Health System Infrastructure .............................................................................................................187 9. Access to Health Care ....................................................................................................................... 203 Appendixes: Data Sources ...................... www.ahrq.gov/research/findings/nhqrdr/nhqrdr12/datasources/index.html Detailed Methods ......................www.ahrq.gov/research/findings/nhqrdr/nhqrdr12/methods/index.html Measure Specifications ..... www.ahrq.gov/research/findings/nhqrdr/nhqrdr12/measurespec/index.html Data Tables ..............................................www.ahrq.gov/research/findings/nhqrdr/nhqrdr12/index.html Highlights From the 2012 National Healthcare Quality and Disparities Reports The U.S. health care system is designed to improve the physical and mental well-being of all Americans by preventing, diagnosing, and treating illness and by supporting optimal function. Across the lifespan, health care helps people stay healthy, recover from illness, live with chronic disease or disability, and cope with death and dying. Quality health care delivers these services in ways that are safe, timely, patient centered, efficient, and equitable. Unfortunately, Americans too often do not receive care they need, or they receive care that causes harm. Care can be delivered too late or without full consideration of a patient’s preferences and values. Many times, our system of health care distributes services inefficiently and unevenly across populations. Some Americans receive worse care than others. These disparities may occur for a variety of reasons, including differences in access to care, social determinants, provider biases, poor provider-patient communication, and poor health literacy. Each year since 2003, the Agency for Healthcare Research and Quality (AHRQ) has reported on progress and opportunities for improving health care quality and reducing health
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