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Quality of Health Care in the United States: a Chartbook

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Quality of Health Care in the United States: a Chartbook Quality of Health Care in the United States: A Chartbook Sheila Leatherman Douglas McCarthy The Commonwealth Fund One East 75th Street New York, NY 10021-2692 Telephone (212) 606-3800 Facsimile (212) 606-3500 [email protected] www.cmwf.org April 2002 Cover photo by Marc Asnin Quality of Health Care in the United States: A Chartbook Sheila Leatherman Douglas McCarthy Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and should not be attributed to The Commonwealth Fund or its directors, officers, or staff. Copies of this report are available from The Commonwealth Fund by calling our toll-free publications line at 1-888-777-2744 and ordering publication number 520. The report can also be found on the Fund’s website at www.cmwf.org. April 2002 Authors Sheila T. Leatherman Principal Investigator President, Foundation for Health Care Policy and Evaluation, Minneapolis Adjunct Professor, School of Public Health, The University of North Carolina, Chapel Hill Douglas B. McCarthy Research Associate and Editor Argus Insights, Inc., Cedar Crest, New Mexico Advisory Board Anne-Marie J. Audet M.D., M.Sc. Assistant Vice President, The Commonwealth Fund Donald M. Berwick, M.D., M.P.P. President and CEO, Institute for Healthcare Improvement Robert S. Galvin, M.D. Director, Global Health Care, General Electric Company Judith H. Hibbard, Dr.P.H. Professor, Department of Planning, Public Policy, and Management, University of Oregon Elizabeth A. McGlynn, Ph.D. Associate Director, RAND Health William L. Roper, M.D., M.P.H. Dean, School of Public Health, The University of North Carolina Production and Dissemination Paul K. Barry Director of Communications, The Commonwealth Fund Susan M. Hayes Communications Manager, Center for Health Care Policy and Evaluation Jenoise Hudgick Administrative Coordinator, Center for Health Care Policy and Evaluation Janine Kennedy Designer, Argus Insights, Inc. Contents Acknowledgements . 7 Introduction . 9 Chapter 1: Effectiveness . 19 Staying Healthy Chart 1–1 Childhood Immunizations . 25 Chart 1–2 Trend in Immunizations for Older Adults . 27 Chart 1–3 Colorectal Cancer Screening . 29 Chart 1–4 Trend in Breast Cancer Screening and Outcomes . 31 Chart 1–5 Smoking Cessation Counseling . 33 Getting Better When Sick Chart 1–6 Antibiotic Treatment for Sore Throat . 35 Chart 1–7 Antibiotic Treatment for Pneumonia . 37 Living with Chronic Illness Chart 1–8 Appropriateness of Procedures as Rated by Expert Consensus . 39 Chart 1–9 Diabetes Management . 41 Chart 1–10 Asthma Management . 43 Chart 1–11 Stroke Prevention for Patients with Atrial Fibrillation . 45 Chart 1–12 Treatment and Outcomes for HIV . 47 Chart 1–13 Medication to Prevent Recurrent Heart Attack . 49 Chart 1–14 Speed to Treatment with Clot-Dissolving Drugs Following a Heart Attack . 51 Chart 1–15 Mental Health Care: Treatment for Depression . 53 Long-Term Care Chart 1–16 Nursing Home Care and Outcomes . 55 Chapter 2: Patient Safety . 57 Chart 2–1 Estimated Deaths Associated with Medical Mistakes Compared to the Leading Causes of Death in the U.S. 61 Chart 2–2 Preventable Adverse Events and Causes: New York . 62 Chart 2–3 Preventable Adverse Events and Outcomes: Colorado/Utah . .63 Chart 2–4 Preventable Adverse Drug Events . 65 Chart 2–5 Trends and Types of Medication-Prescribing Mistakes . 67 Chart 2–6 Potentially Inappropriate Prescribing for the Elderly . 69 Chapter 3: Access and Timeliness . 71 Chart 3–1 Effect of Being Uninsured on Access to Primary Care . 75 Chart 3–2 Effect of Being Uninsured on Access to Preventive Care (Part I) . 76 Chart 3–3 Effect of Being Uninsured on Access to Preventive Care (Part II) . 77 Chart 3–4 Unmet Needs of Children with Special Health Care Needs . 79 Chart 3–5 Effect of Having a Regular Source of Health Care on Access to Preventive Care . 81 Chart 3–6 Timely Initiation of Prenatal Care . 83 Chart 3–7 Dental Care . 85 Chapter 4: Focus on the Patient . 87 Chart 4–1 Perceptions of Health Care Quality . 91 Chart 4–2 Public Perceptions of the Health Care System . 93 Chart 4–3 Consumer Assessment of Health Plans, Overall Ratings . 95 Chart 4–4 Consumer Assessment of Health Plans, Ratings of Access and Timeliness . 96 Chart 4–5 Consumer Assessment of Health Plans, Ratings of Physician and Health Plan Communications . 97 Chart 4–6 Patient Reports of Problems with Hospital Care . 99 Chart 4–7 Time Spent with Physician . 101 Chart 4–8 Satisfaction with Nursing Home Care . 103 Chart 4–9 Ratings of Nursing Home Staff and Staffing Levels . 104 Chart 4–10 Nursing Home Quality of Life . 105 Chapter 5: Disparities in Health Care . 107 Staying Healthy Chart 5–1 Racial/Ethnic Disparity in Preventive Care . 111 Living with Chronic Illness Chart 5–2 Racial Disparity in Lung Cancer Surgery and Survival . 113 Chart 5–3 Racial Disparity in Use of Invasive Heart Procedures . 115 Chart 5–4 Gender Disparity in Heart Attack Treatment . 117 Chart 5–5 Racial Disparity in Access to Kidney Transplants . 119 Chart 5–6 Racial Disparity in Cancer Pain Management . 121 Patient Experience Chart 5–7 Effect of Race/Ethnicity and Language on Parents’Assessments of Pediatric Care in Medicaid Health Plans . 123 Chapter 6: Capacity to Improve . 125 Staying Healthy Chart 6–1 Improving Immunization Rates . 129 Getting Better When Sick Chart 6–2 Reducing Unnecessary Antibiotic Use . 131 Living with Chronic Illness Chart 6–3 Improving Diabetes Management . 133 Chart 6–4 Improving Medical Treatment for Heart Attack . 135 Chart 6–5 Improving Outcomes of Heart Bypass Surgery . 137 Chart 6–6 Improving Treatment and Outcomes for Depression . 139 Long-Term Care Chart 6–7 Reducing Pressure Ulcers in the Nursing Home . 141 Patient Safety Chart 6–8 Preventing Medication Mistakes . 143 Technical Appendix . ..
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