Press Release Date: April 13, 2010
Improvements in patient safety continue to lag, according
to the 2009 National Healthcare Quality Report and National Healthcare
Disparities Report issued today by the U.S. Department of Health and Human
Services' Agency for Healthcare Research and Quality.
Very little progress has been made on eliminating health care-associated infections
(HAIs), according to a new section in the 2009 quality report. For example,
of the five types of HAIs in adult patients who are tracked in the reports:
- Rates
of postoperative sepsis, or bloodstream infections, increased by 8 percent.
- Postoperative catheter-associated urinary tract infections increased by 3.6
percent.
- Rates of selected infections due to medical care increased by 1.6 percent.
- There was no change in the number of bloodstream infections associated with central
venous catheter placements, which are tubes placed in a large vein in the patient's
neck, chest, or groin to give medication or fluids or to collect blood samples.
- However, rates of postoperative pneumonia improved by 12 percent.
In addition,
although rates are improving incrementally, blacks, Hispanics, Asians, and
American Indians are less likely than whites to receive preventive antibiotics
before surgery in a timely manner.
"Despite promising improvements in a few areas of health care, we are not achieving
the more substantial strides that are needed to address persistent gaps in
quality and access," said AHRQ Director Carolyn M. Clancy, M.D. "Targeted
AHRQ-funded research in Michigan has shown that infection rates of HAIs can
be radically reduced. We are now working to make sure that happens in
all hospitals."
Over 100
participating hospital intensive care units in Michigan have been able to keep
the rates of central line-associated bloodstream infections to near zero, 3
years after adopting standardized procedures. The project, conducted
by the Michigan Health and Hospital Association Keystone Center, involved the
use of a comprehensive unit-based safety program to reduce these potentially
lethal infections. Last year, AHRQ announced new funding that has expanded
the project to all 50 states, Puerto Rico, and the District of Columbia.
AHRQ's annual quality and disparities reports, which are mandated by Congress, were
first published in 2003. The reports show trends by measuring health
care quality for the nation using a group of credible core measures. The data
are based on more than 200 health care measures categorized in four areas of
quality: effectiveness, patient safety, timeliness, and patient-centeredness.
The 2009
reports include a new section on lifestyle modifications, because preventing
or reducing obesity is a crucial goal for many Americans and an important task
for health care providers.
The reports found:
- One-third of obese adults have never received advice from their doctor about exercise.
- Obese adults who are black, Hispanic, poor or have less than a high school education
are less likely to receive diet advice from their doctor.
- Most overweight children and one-third of obese adults report that they have not
been told by their doctor that they are overweight.
- Most American children have never received counseling from their health care provider
about exercise, and almost half have never received counseling about healthy eating.
The reports
indicate that the lack of health insurance slows improvement in health care
quality and reduction of disparities. For many services, not having insurance
is the single strongest predictor of poor quality care, exceeding the effects
of race, ethnicity, income or education.
Americans
with no insurance are much less likely than those with private insurance to
obtain recommended care, especially preventive services and management for
diabetes. While differences between blacks and whites in the rates of
lack of insurance have narrowed in the past decade, disparities related to
ethnicity, income and education remain large.
The quality
and disparities reports are available online at http://www.ahrq.gov/qual/qrdr09.htm,
by calling 1-800-358-9295, or by sending an e-mail to ahrqpubs@ahrq.hhs.gov.
For more information, please contact AHRQ Public Affairs: (301) 427-1855
or (301) 427-1244.
Use Twitter to get AHRQ news updates: http://www.twitter.com/ahrqnews/
Internet Citation:
Annual Quality and Disparities Reports Include Data on
Rates of Health Care-Associated Infections, Obesity and Health Insurance.
Press Release, April 13, 2010. Agency for Healthcare Research and Quality,
Rockville, MD. http://www.ahrq.gov/news/press/pr2010/qrdr09pr.htm