On Tuesday night, the new coalition the Friends of NIMHD (National Institute on Minority Health and Health Disparities), housed at AcademyHealth, hosted a welcoming reception for new NIMHD Director Dr. Eliseo J. Pérez-Stable. In his role, Dr. Pérez-Stable will oversee the Institute within the National Institutes of Health (NIH) responsible for leading scientific research to improve minority health and eliminate health disparities—this includes not only the research component, but also ensuring a diverse research workforce, spreading research information, and fostering collaborations and partnerships. This mission is all done in support of the health system’s collective efforts to achieve the three aims of better care, smarter spending, and healthier people.
Much progress has been made in this space, but much remains to be done. Specifically, greater strides need to be made to address disparities in health care.
A positive first step was the transition of the National Center on Minority Health and Health Disparities to the NIMHD, an Institute at NIH; this move signaled to the community a more prominent focus on minority health and health disparities on the federal government agenda.
The Agency for Healthcare Research and Quality (AHRQ) is another entity that has recognized this need and acted upon it when, earlier this year, it changed the format of its Congressionally-mandated National Healthcare Quality and Disparities Report (QDR) to make the content easier to understand and more actionable for patients, physicians, policymakers, and care providers. The report now also tracks measures that align with the National Quality Strategy (NQS)—mandated by the Affordable Care Act (ACA)—since the NQS sets national priorities for health care quality improvement and the QDR tracks quality, access and disparities. The two go hand-in-hand.
In addition to releasing just the mandated report, AHRQ concurrently published QDR Chartbooks, which provide information on individual measures, such as rural health care and women’s health care, and the QDR Data and Tools, which allow users to drill down into the quality and disparities measures on both the state and national levels and which provide snapshot summaries of what’s happening across various measures.
For example, here in Washington, D.C. the performance of the District across all quality measures ranks in the “Average” range:
Image Source: District of Columbia, State Snapshot, National Healthcare Quality and Disparities Reports, Agency for Healthcare Research and Quality, http://nhqrnet.ahrq.gov/inhqrdr/District%20of%20Columbia/snapshot/summary/All_Measures/All_Topics
To determine why D.C. received this ranking, AHRQ allows users to “Review Underlying Data,” which shows the rating under various quality measures (e.g., Hospice patients who received the right amount of medicine for pain, children ages 19-35 months who received 3 or more doses of polio vaccine). Users can see which measures achieved the benchmark, which were close to the benchmark, and which were far from the benchmark. The measures are also broken down by Race and Ethnicity.
As panelist Sabrina Matoff-Stepp, Health Resources and Services Administration, said during her presentation at the 2015 AHRQ Research Conference, co-hosted by AHRQ and AcademyHealth, data tells the story not only of a specific population (e.g., women), but also the story of the population to whom we’re comparing them, whether it be individuals of a different gender or racial/ethnic group.
Overall this story has a positive attribute; key findings from the 2014 QDR demonstrate that the nation has made progress in improving the health care delivery system to achieve the aims of better care. The QDR’s strength lies in that it identifies for policymakers and health care delivery organizations the system’s strengths and weaknesses, or where there is room for improvement (whether within specific populations or in the way care itself is being delivered).
At the end of the day, “Our data is only as good as what we do with it,” as Matoff-Stepp said. The QDR provides a solid foundation for those who work day in and day out to improve the health care system, giving them tools to better understand where gaps exist and thus, equipping them with the information they need to tackle those issues moving forward.
To access the 2014 QDR and its supporting materials, visit the AHRQ website.
*The Agency for Healthcare Research and Quality has been negatively targeted (for elimination by the House and for a 35 percent funding reduction by the Senate) in fiscal year 2016 appropriations. The health services research it supports is critical to improving the health research enterprise. Learn more and help #SaveAHRQ by visiting the AcademyHealth website.