Report Finds U.S. Health Quality Stagnant


A recent report (PDF) from The Commonwealth Fund that suggests the quality and efficacy of the U.S. healthcare system has remained relatively static in the past three years has bright spots for HM, an academic hospitalist says.

Kedar Mate, MD, assistant professor of medicine with the division of hospital medicine at Weill Cornell Medical School in New York City, says the report, which was compiled before any of the facets of the Affordable Care Act were implemented, helps argue why hospitalists are poised to take the reins of those needed quality reforms.

"They're the natural leaders of this work moving forward from the physician perspective," says Dr. Mate, a faculty member at the Institute for Healthcare Improvement in Cambridge, Mass. "They have a strong role to play in shepherding and championing and really being the arms and legs of the quality and safety movement, in many ways. Not only leading it, but actually executing it."

The report released last month, "Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2011," measures 42 indicators of healthcare quality, access, efficiency, equity, and healthy lives. In overall terms, the U.S. score has varied only slightly in the third national scorecard. And while the report cautions that year-to-year analyses of quality measures are not directly comparable because of changing categories, Dr. Mate notes there have been significant improvements in areas that HM and health system improvement efforts have targeted.

The study, for example, reports half of adults with high blood pressure had the condition under control in 2007-2008, up from 31% in 1999-2000. The data also show that the rate of controlled blood sugar levels in adults with diabetes ticked up to 86% in 2007-2008 from 79% in 1999-2000.

"Where we turn our attention, particularly with focused quality initiatives, we're seeing some measurable change," Dr. Mate says. "There's absolutely value in identifying and knowing where we are seeing benefits, because those ought to be built upon."

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