National Healthcare Disparities Report, 2013
Highlights: Text Descriptions
Figure H.1. Average proportion of recommended care received across a panel of quality of care measures, 2005-2010
| 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|
| Percent | 66.4 | 68.3 | 69.4 | 69.3 | 69.9 | 69.8 |
Figure H.2. Number and proportion of all quality measures that are improving, not changing, or worsening, overall and for select populations
| Improving | No Change | Worsening | |
|---|---|---|---|
| Total (n=168) | 100 | 57 | 11 |
| Hispanic (n=168) | 98 | 60 | 10 |
| Black (n=168) | 96 | 61 | 11 |
| Asian (n=123) | 70 | 49 | 4 |
| Poor (n=95) | 51 | 37 | 7 |
| AI/AN (n=88) | 37 | 48 | 3 |
| Neither Activity Limitation (n=26) | 16 | 8 | 2 |
| Basic Activity Limitations (n=25) | 9 | 14 | 2 |
| Complex Activity Limitations (n=24) | 5 | 17 | 2 |
Key: AI/AN = American Indian or Alaska Native; n = number of measures.
Improving = Quality is going in a positive direction at an average annual rate greater than 1% per year.
No Change = Quality is not changing or is changing at an average annual rate less than or equal to 1% per year.
Worsening = Quality is going in a negative direction at an average annual rate greater than 1% per year.
Note: For the vast majority of measures, trend data are available from 2000-2002 to 2010-2011. Basic activity limitations include problems with mobility, self-care, domestic life, or activities that depend on sensory functioning. Complex activity limitations include limitations experienced in work or in community, social, and civic life.
Figure H.3. Number and proportion of measures that are improving, not changing, or worsening, by setting of care
| Improving | No Change | Worsening | |
|---|---|---|---|
| Hospital (n=39) | 29 | 9 | 1 |
| Home Health & Hospice (n=15) | 9 | 6 | NA |
| Nursing Home (n=19) | 11 | 7 | 1 |
| Ambulatory (n=86) | 45 | 34 | 7 |
Key: n = number of measures.
Improving = Quality is going in a positive direction at an average annual rate greater than 1% per year.
No Change = Quality is not changing or is changing at an average annual rate less than or equal to 1% per year.
Worsening = Quality is going in a negative direction at an average annual rate greater than 1% per year.
Note: For the vast majority of measures, trend data are available from 2000-2002 to 2010-2011.
Figure H.4a. Quality of care, by setting and state, quality of ambulatory care
| Lowest Quality Quartile | Second Quartile | Third Quartile | Highest Quality Quartile |
|---|---|---|---|
| Arkansas | Alabama | Arizona | Colorado |
| Georgia | Alaska | California | Connecticut |
| Idaho | Florida | Hawaii | Delaware |
| Kentucky | Maryland | Kansas | Iowa |
| Illinois | Montana | Michigan | Maine |
| Indiana | Nevada | Nebraska | Massachusetts |
| Louisiana | New Mexico | New Jersey | Minnesota |
| Mississippi | North Carolina | New York | New Hampshire |
| Missouri | Oklahoma | Oregon | North Dakota |
| Ohio | Pennsylvania | Rhode Island | Utah |
| South Carolina | Tennessee | South Dakota | Vermont |
| Texas | Wyoming | Virginia | Washington |
| West Virginia | NA | NA | Wisconsin |
Figure H.4b. Quality of care, by setting and state, quality of hospital care
| Lowest Quality Quartile | Second Quartile | Third Quartile | Highest Quality Quartile |
|---|---|---|---|
| Arizona | Alabama | Colorado | Idaho |
| Arkansas | Alaska | Florida | Indiana |
| Hawaii | California | Georgia | Iowa |
| Kentucky | Connecticut | Illinois | Maine |
| Louisiana | Delaware | Nebraska | Massachusetts |
| Maryland | Kansas | New Jersey | Michigan |
| Mississippi | Missouri | Oregon | Minnesota |
| New Mexico | Montana | Pennsylvania | New Hampshire |
| New York | Nevada | South Dakota | North Carolina |
| Oklahoma | North Dakota | Tennessee | Ohio |
| West Virgina | Rhode Island | Texas | South Carolina |
| Wyoming | Washington | Vermont | Utah |
| NA | NA | Virginia | Wisconsin |
Figure H.4c. Quality of care, by setting and state, quality of home health and hospice care
| Lowest Quality Quartile | Second Quartile | Third Quartile | Highest Quality Quartile |
|---|---|---|---|
| Alaska | California | Alabama | Delaware |
| Arkansas | Colorado | Arizona | Kansas |
| Connecticut | Florida | Georgia | Michigan |
| Hawaii | Idaho | Illinois | Missouri |
| Kentucky | Iowa | Indiana | Nevada |
| Minnesota | Louisiana | Maine | New Jersey |
| New Mexico | Mississippi | Maryland | North Carolina |
| New York | Nebraska | Massachusetts | North Dakota |
| Ohio | South Dakota | Montana | Pennsylvania |
| Oklahoma | Tennessee | New Hampshire | Rhode Island |
| Oregon | West Virginia | Vermont | South Carolina |
| Texas | Wyoming | Wisconsin | Utah |
| Washington | NA | NA | Virginia |
Figure H.4d. Quality of care, by setting and state, quality of nursing home care
| Lowest Quality Quartile | Second Quartile | Third Quartile | Highest Quality Quartile |
|---|---|---|---|
| California | Arizona | Alaska | Alabama |
| Florida | Colorado | Connecticut | Arkansas |
| Illinois | Idaho | Delaware | Hawaii |
| Louisiana | Indiana | Georgia | Iowa |
| Maine | Kentucky | Kansas | Massachusetts |
| Maryland | Montana | Mississippi | Minnesota |
| Michigan | New Mexico | New Hampshire | Missouri |
| Nevada | North Carolina | North Dakota | Nebraska |
| Oregon | Ohio | Oklahoma | New Jersey |
| Pennsylvania | Texas | Rhode Island | New York |
| Virginia | Utah | Tennessee | South Carolina |
| Washington | Vermont | Wyoming | South Dakota |
| West Virginia | NA | NA | Wisconsin |
Source: Agency for Healthcare Research and Quality, 2012 State Snapshots.
Note: States are divided into quartiles based on health care score for each setting of care.
Figure H.5. Number and proportion of all access measures that are improving, not changing, or worsening, overall and for select populations
| Improving | No Change | Worsening | |
|---|---|---|---|
| Total (n=15) | 1 | 9 | 5 |
| AI/AN (n=11) | NA | 8 | 3 |
| Black (n=15) | 1 | 10 | 4 |
| Asian (n=13) | 2 | 8 | 3 |
| Poor (n=15) | 5 | 7 | 3 |
| Hispanic (n=15) | 4 | 9 | 2 |
| Basic Activity Limitation (n=14) | 3 | 6 | 5 |
| No Activity Limitation (n=15) | 1 | 9 | 5 |
| Complex Activity Limitation (n=15) | 2 | 9 | 4 |
Key: AI/AN = American Indian or Alaska Native; n = number of measures.
Improving = Access is going in a positive direction at an average annual rate greater than 1% per year.
No Change = Access is not changing or is changing at an average annual rate less than or equal to 1% per year.
Worsening = Access is going in a negative direction at an average annual rate greater than 1% per year.
Note: For the vast majority of measures, trend data are available from 2000-2002 to 2010-2011. Basic activity limitations include problems with mobility, self-care, domestic life, or activities that depend on sensory functioning. Complex activity limitations include limitations experienced in work or in community, social, and civic life.
Figure H.6. Average proportion of people across a panel of access to care measures reporting barriers to care, by race/ethnicity and family income, 2002-2011
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | |
|---|---|---|---|---|---|---|---|---|---|---|
| Total | 24.1% | 24.2% | 24.3% | 24.7% | 25.2% | 25.2% | 25.4% | 26.3% | 26.4% | 26.1% |
| Hispanic | 35.4% | 35.3% | 35.6% | 36.2% | 35.5% | 35.3% | 35.9% | 36.9% | 35.8% | 35.2% |
| Black | 27.3% | 28.2% | 28.1% | 28.7% | 28.6% | 28.0% | 28.8% | 29.6% | 30.2% | 29.5% |
| White | 21.4% | 21.5% | 21.5% | 21.7% | 22.5% | 22.6% | 22.7% | 23.5% | 23.6% | 23.2% |
| High Income | 16.1% | 16.0% | 15.6% | 16.3% | 16.7% | 16.5% | 17.1% | 16.7% | 17.3% | 16.6% |
| Middle Income | 22.7% | 22.5% | 23.4% | 23.5% | 24.3% | 24.9% | 24.2% | 25.5% | 24.7% | 25.1% |
| Low Income | 32.0% | 32.5% | 32.0% | 32.8% | 33.3% | 33.4% | 33.7% | 34.3% | 35.0% | 34.1% |
| Poor | 36.6% | 36.6% | 37.1% | 37.4% | 37.1% | 37.6% | 38.4% | 39.1% | 38.1% | 37.6% |
Note: White and Black are non-Hispanic; Hispanic includes all races.
Figure H.7. Number and proportion of all quality measures for which members of selected groups experienced better, same, or worse quality of care compared with reference group
| Better | Same | Worse | |
|---|---|---|---|
| Poor vs. High Income (n=107) | 6 | 35 | 68 |
| Black vs. White (n=196) | 28 | 86 | 82 |
| Hispanic vs. White (n=184) | 37 | 75 | 72 |
| AI/AN vs. White (n=114) | 16 | 61 | 37 |
| Asian vs. White (n=171) | 48 | 81 | 42 |
| Complex vs. No Activity Limitation (n=37) | 9 | 15 | 13 |
| Basic vs. No Activity Limitation (n=37) | 10 | 15 | 12 |
Key: AI/AN = American Indian or Alaska Native; NHW = non-Hispanic White; n = number of measures.
Better = Population received better quality of care than reference group.
Same = Population and reference group received about the same quality of care.
Worse = Population received worse quality of care than reference group.
Note: For each measure, the most recent data available to our team were analyzed; for the majority of measures, this represents data from 2010 and 2011. Basic activity limitations include problems with mobility, self-care, domestic life, or activities that depend on sensory functioning. Complex activity limitations include limitations experienced in work or in community, social, and civic life.
Figure H.8. Number and proportion of all access measures for which members of selected groups experienced better, same, or worse access to care compared with reference group
| Better | Same | Worse | |
|---|---|---|---|
| Poor vs. High Income (n=21) | NA | 1 | 20 |
| Hispanic vs. White (n=21) | 4 | 4 | 13 |
| AI/AN vs. White (n=14) | NA | 8 | 6 |
| Black vs. White (n=21) | 2 | 12 | 7 |
| Asian vs. White (n=20) | 4 | 11 | 5 |
| Complex vs. No Activity Limitation (n=19) | 4 | 3 | 12 |
| Basic vs. No Activity Limitation (n=18) | 4 | 3 | 11 |
Key: AI/AN = American Indian or Alaska Native; n = number of measures.
Better = Population had better access to care than reference group.
Same = Population and reference group had about the same access to care.
Worse = Population had worse access to care than reference group.
Note: For each measure, the most recent data available to our team were analyzed; for the majority of measures, this represents data from 2010 and 2011. Basic activity limitations include problems with mobility, self-care, domestic life, or activities that depend on sensory functioning. Complex activity limitations include limitations experienced in work or in community, social, and civic life.
Figure H.9. Number and proportion of all quality measures for which disparities related to race, ethnicity, income, and activity limitation are improving, not changing, or worsening
| Worsening | No Change | Improving | |
|---|---|---|---|
| Black vs. White (n=168) | 12 | 125 | 31 |
| Hispanic vs. White (n=158) | 19 | 110 | 29 |
| Poor vs. High Income (n=93) | 6 | 70 | 17 |
| Asian vs. White (n=123) | 14 | 89 | 20 |
| AI/AN vs. White (n=88) | 15 | 64 | 9 |
| Complex vs. No Activity Limitation (n=24) | 3 | 20 | 1 |
| Basic vs. No Activity Limitation (n=25) | 1 | 23 | 1 |
Key: AI/AN = American Indian or Alaska Native; n = number of measures.
Improving = Disparity is getting smaller at a rate greater than 1% per year.
No Change = Disparity is not changing or is changing at a rate less than or equal to 1% per year.
Worsening = Disparity is getting larger at a rate greater than 1% per year.
Note: For the vast majority of measures, trend data are available from 2000-2002 to 2010-2011. Basic activity limitations include problems with mobility, self-care, domestic life, or activities that depend on sensory functioning. Complex activity limitations include limitations experienced in work or in community, social, and civic life.
Figure H.10. Number and proportion of all access measures for which disparities related to race, ethnicity, income, and activity limitation are improving, not changing, or worsening
| Worsening | No Change | Improving | |
|---|---|---|---|
| Poor vs. High Income (n=14) | 1 | 10 | 3 |
| Hispanic vs. White (n=15) | 1 | 11 | 3 |
| Asian vs. White (n=12) | NA | 10 | 2 |
| Black vs. White (n=14) | NA | 13 | 1 |
| AI/AN vs. White (n=10) | NA | 10 | NA |
| Basic vs. No Activity Limitation (n=15) | 2 | 9 | 4 |
| Complex vs. No Activity Limitation (n=15) | 1 | 12 | 2 |
Key: AI/AN = American Indian or Alaska Native; n = number of measures.
Improving = Disparity is getting smaller at a rate greater than 1% per year.
No Change = Disparity is not changing or is changing at a rate less than or equal to 1% per year.
Worsening = Disparity is getting larger at a rate greater than 1% per year.
Note: For the vast majority of measures, trend data are available from 2000-2002 to 2010-2011. Basic activity limitations include problems with mobility, self-care, domestic life, or activities that depend on sensory functioning. Complex activity limitations include limitations experienced in work or in community, social, and civic life.
Figure H.11. Percentage of quality measures in the 2006, 2011, 2012, and 2013 reports for which a reliable estimate could not be generated
| Year | Asian | NHOPI | AI/AN | Hispanic | Poor |
|---|---|---|---|---|---|
| 2006 Reports | 33% | 93% | 47% | 12% | 60% |
| 2011 Reports | 19% | 85% | 42% | 7% | 46% |
| 2012 Reports | 14% | 82% | 42% | 7% | 45% |
| 2013 Reports | 12% | 75% | 40% | 6% | 40% |
Key: NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native.
Page originally created May 2014
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