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2007 National Healthcare Quality Report (NHQR). Health care quality continues to improve, but the rate of improvement has slowed. Released March 3, 2008. Annual Median Rate of Change. The annual median rate of change from 1994 to 2005 was 2.3%

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2007 national healthcare quality report nhqr
2007 National Healthcare Quality Report (NHQR)

Health care quality continues to improve, but the rate of improvement has slowed

Released March 3, 2008

annual median rate of change
Annual Median Rate of Change
  • The annual median rate of change from 1994 to 2005 was 2.3%
  • From 2000 to 2005, the annual median rate of change was 1.5%

n=number of measures

improvement in core measures
Improvement in Core Measures
  • Most measures show some improvement
  • Of the 41 core measures reported with data that span 1994-2005:
    • 27 improved
    • 6 declined
    • 6 showed no change
variation in health care quality
Variation in Health Care Quality
  • Variation in quality of health care across the Nation is decreasing, but not for all measures
  • More measures have seen progress in terms of decreases in variation between the best performing State and the worst performing State between 2000 and 2005:
    • Variability decreased for 28 measures
    • Variability increased for 13 measures
    • There was no change for 18 measures
example of decreased variation
Example of Decreased Variation

Heart attack patients given smoking cessation counseling while hospitalized

Source: CMS, Medicare Quality Improvement Organization Program

patient safety
Patient Safety
  • The safety of health care has improved since 2000, but more needs to be done

n=number of measures

rates of improvement
Rates of Improvement
  • Safety improved slightly between 2000 and 2005, at an annual rate of 1%
  • Other areas improved at significantly greater rates, such as care for heart disease (5.6%)
rates of improvement1
Rates of Improvement
  • Areas where significant attention has been concentrated, such as appropriate timing of antibiotics for surgery and reducing medication errors, have shown progress:
    • Over 30% more patients received appropriate timing for antibiotics before and after surgery in 2005 than in 2004
    • From 2004 to 2005, adverse drug events from warfarin and low-molecular-weight heparin declined 21% and 28%, respectively
    • Deaths following complications of care declined 2.4% from 1994 to 2004
patient safety data
Patient Safety Data
  • In many areas, data needed to track patient safety effectively are not available
  • In most cases, clinicians lack basic monitoring data on medical errors and adverse events. For example:
    • Only 25 of 41 safety measures in the full NHQR measure set have data available for tracking recent trends
    • No national data systems currently report data on safety at a State or local level
    • Because adverse events and medical errors are rare events from a statistical perspective, it is difficult to compare across time or patient groups
origin of nhqr
Origin of NHQR
  • Health and Human Services Secretary required to submit annual report to Congress:
    • National trends in health care quality (National Healthcare Quality Report, or NHQR)
    • Prevailing disparities in health care delivery as it relates to racial factors and socioeconomic factors in priority populations (National Healthcare Disparities Report, or NHDR)

Mandated by Congress in Healthcare Research and Quality Act (PL. 106-129)

nhqr and nhdr goals
NHQR and NHDR Goals
  • Provide a snapshot of health care delivery
    • 41 core measures of quality and access
    • 211 total measures
  • Indicate the biggest gaps in care
  • Show national and State trends
  • Tell us how we can reach our goals
  • Help align measures across public and private quality initiatives
nhqr and nhdr framework
NHQR and NHDR Framework

Source: Institute of Medicine Committee. “Envisioning the National Health Care Quality Report,” 2001

nhqr nhdr content and organization
NHQR/NHDR Content and Organization
  • Effectiveness
    • Cancer
    • Diabetes
    • End Stage Renal Disease (ESRD)
    • Heart Disease
    • HIV and AIDS
    • Maternal and Child Health
    • Mental Health and Substance Abuse
    • Nursing Home, Home Health,

and Hospice Care

  • Patient Safety
  • Timeliness
  • Patient Centeredness
  • Access to Health Care
  • Priority Populations

*Also includes a chapter on Efficiency



new in the 2007 nhqr
New in the 2007 NHQR
  • Chapter 2, Cancer: Cancer treatment measures (two for breast cancer, one for colon cancer) from National Cancer Data Base, American Cancer Society and American College of Surgeons
  • Chapter 2, HIV and AIDS: HIV testing measures, CDC National Survey on Family Growth
  • Chapter 2, Nursing Home and Home Health: Pain management for nursing home residents, CDC National Nursing Home Survey
  • Chapter 6, Efficiency
for more information
For more information…

NHQR and NHDR Web page http://www.ahrq.gov/qual/qrdr07.htm

NHQRnet for data tables and queries


Request a copy (AHRQ publication no. 08-0040) from AHRQ Publications Clearinghouse

1-800-358-9295 or AHRQPubs@ahrq.hhs.gov