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  • Washington Highlights

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

    Philip Alberti, Senior Director, Health Equity Research and Policy

    The Agency for Healthcare Research and Quality (AHRQ) April 10 released the 2014 National Quality and Disparities Report, which 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, very 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. The 12th annual report draws on data from more than 40 national sources and presents trends through 2012 or 2014 depending on the analysis.

    According to the 2014 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 33-66 percent of measures, as compared with Whites. 

    Additionally, the report shows that there was very little change in racial/ethnic quality disparities through 2012, though for people in poor households, more measures showed worsening disparities than improvement.  However, some racial and ethnic disparities in childhood immunization were eliminated according to the report, showing that such elimination is possible.

    For the first time, the report tracks performance measures aligned with the National Quality Strategy (NQS), a program mandated by the ACA and shows that improvements were seen for most of the programs priorities, including patient safety where a 17 percent decline in hospital-acquired conditions was documented.

    However, the report notes that disparities in quality and outcomes were largely unchanged through 2012 and that some inequities related to hospice care and chronic disease management grew larger. AHRQ also recommends data and measures be improved for smaller groups like Native Hawaiians and people who are lesbian, gay, bisexual or transgender.