Hospital quality improvement efforts are paying off and are outpacing improvements in other health settings, according to reports from the Agency for Healthcare Research and Quality. Three-quarters of hospital quality measures showed significant improvement, compared with 60 percent for home health and nursing home care, and about half for ambulatory settings.

The 2013 National Healthcare Quality Report and National Healthcare Disparities Report show that Americans are receiving recommended medical services 70 percent of the time. The data are based on measures categorized in eight areas of quality: effectiveness, patient safety, timeliness, patient-centeredness, care coordination, efficiency, health system infrastructure and access.

The reports also indicate that public reporting of quality measures may have contributed to improvement. Fourteen of the 16 quality measures that reached a 95 percent performance level were publicly reported by the Centers for Medicare & Medicaid Services. Another four CMS measures are among those improving at the fastest pace. Every CMS measure tracked in the reports and reported on the Hospital Compare website showed improvement over time.

Rates of some health care-associated infections are beginning to fall while processes to prevent hospital readmission are improving. Quality also has improved for measures on adolescent vaccination, HIV treatment, colon cancer surgical care and hospital care for patients with heart problems and pneumonia. Quality worsened, however, for measures on diabetes checkups, Pap tests, maternal deaths at delivery and preventive care for patients with asthma.

The reports also found deficiencies regarding health care access, with 26 percent of Americans (especially racial and ethnic minorities and low-income people) reporting difficulties getting care. Most disparities in quality that were related to race, ethnicity or income showed no significant change. However, for blacks, Hispanics, Asians and poor people, the number of disparities showing improvement was larger than the number of disparities that were getting worse.

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