Every year the Agency for Healthcare Research & Quality evaluates the level of quality in American health care. The report generally contains useful data. (AHRQ Report) In general, the Agency found that overall quality was improving slightly, patients were having more difficulty getting access to care and disparities across income and ethnic groups were not lessening. Of particular concern were improving quality in diabetes care, maternal and child care and lowering rates of adverse events or errors as a result of medical care. The overall quality of care is best in a group of states in the upper Northeast, Maine, Vermont, New Hampshire, Massachusetts, and in the upper Midwest, Minnesota, Wisconsin, Iowa and the Dakotas, and lowest in the south-southwest area, including Texas, Arkansas, Louisiana and Mississippi. Surprisingly, California ranks low on a number of measures. These regional differences are almost certainly linked solely to socioeconomic factors and may not say much about the competency of health care providers in these areas. But it does reflect a need to take stronger action to ensure that poorer patients get appropriate care. This is not always or even often a financial issue, but one relating to personal responsibility for good health behaviors. Across common quality measures, some were improving, usually because they are measures CMS uses in its pay-for-performance programs, but some are worsening also. The worsening of some diabetes care measures is surprising, given the emphasis on improving care for that disease. Much of the report is a summary of performance on the hundreds of measures included in analyzing quality.
