AHRQ Report Shows that Despite Improvements in Quality and Access, Disparities Persist

The Agency for Healthcare Research and Quality (AHRQ) May 3 released the 2015 National Healthcare Quality and Disparities Report and 5th Anniversary Update on the National Quality Strategy.

The 13th annual report, which tracks 250 health care process, outcome, and access measures and presents trends through 2013 or 2015, provides a snapshot of health care disparities and covers a period after the implementation of insurance expansion included in the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152). The report indicates that while insurance coverage improved substantially for Black and Hispanic adults, few health care disparities were reduced or eliminated.

Since 2003, AHRQ has been congressionally mandated to report on the progress and challenges to achieving health care equity in the United States. According to the 2015 report, notwithstanding parallel improvements to health care access for all racial/ethnic and income groups, significant gaps persist: poor people had less access to care than wealthy Americans for all access measures, while Blacks, Native Americans, and Hispanics experienced decreased access for 33-70 percent of measures as compared with Whites. The report shows that there was very little change in racial/ethnic quality disparities through 2013, though more measures showed worsening disparities than improvement for people in poor households. 

The 2015 National Healthcare Quality and Disparities Report tracks performance measures aligned with the National Quality Strategy (NQS), a program mandated by the ACA. The report shows that improvements were seen for most of the NQS priorities, including patient safety, where a 17 percent decline in hospital-acquired conditions between 2010 and 2014 was documented.

There has been a change in disparities over time across NQS priorities. The report shows that 45 percent of disparities related to Care Coordination and Effective Treatment were getting smaller and about 30 percent of disparities related to Patient Safety, Person Centered Care, and Healthy Living were getting smaller. However, some quality disparities still persist among poor people, Hispanics, and Blacks.

For the first time, the 2015 National Healthcare Quality and Disparities Report and National Quality Strategy Update tracks the progress made to address the priorities of the National Quality Strategy at the 5-year anniversary mark.  This joint effort within AHRQ provides a more comprehensive assessment of the national efforts to reduce inequities in health and health care.