National Healthcare Disparities Report, 2006

The Agency for Healthcare Research and Quality (AHRQ) is pleased to release the 2006 National Healthcare Disparities Report (NHDR) on behalf of the U.S. Department of Health and Human Services (HHS) and in collaboration with an HHS-wide Interagency Work Group. Like previous reports, the 2006 NHDR also received significant guidance from AHRQ leadership and AHRQ's National Advisory Committee. This fourth annual report to Congress provides a comprehensive national overview of disparities in health care among racial, ethnic, and socioeconomic groups in the general U.S. population and within priority populations and tracks the progress of activities to reduce disparities. The NHDR tracks disparities related to quality of health care and access to health care. Measures of health care quality address the extent to which providers and hospitals deliver evidence-based care for specific services as well as the outcomes of the care provided. They are organized around four dimensions of quality- effectiveness, patient safety, timeliness, and patient centeredness-and cover four stages of care-staying healthy, getting better, living with illness or disability, and coping with the end of life. Measures of health care access include assessments of how easily patients are able to get needed health care and their actual use of services. They are organized around two dimensions of access-facilitators and barriers to care and health care utilization. The NHDR is complemented by its companion report, the National Healthcare Quality Report (NHQR), which uses the same quality measures as the NHDR to provide a comprehensive overview of the quality of health care in America. Both reports measure health care quality and track changes over time but with different orientations. The NHQR addresses the current state of health care quality and the opportunities for improvement for all Americans as a whole. This perspective is useful for identifying where we are doing well as a Nation and where more work is needed. The NHDR addresses the distribution of improvements in health care quality and access across the different populations that make up America. This perspective is useful for ensuring that all Americans benefit from improvements in care. Perspectives from both reports are needed for a complete understanding of quality of health care, and both reports support HHS Secretary Mike Leavitt's 500- Day Plan to fulfill the President's vision of a healthier America, specifically in the areas of better transparency of health care quality information and eliminating inequities in health care. This year's NHDR and NHQR continue the tracking of trends across a broad array of measures of health care quality and access for many racial and ethnic minority groups and socioeconomic groups. In addition, the 2006 reports incorporate improved measures and methods for summarizing quality and disparities in health care, including new composite measures and expanded analyses of trends in disparities. This section offers a concise overview of findings from the 2006 NHDR. More detailed findings are presented in the chapters that follow. In the 2006 NHDR, four key themes are highlighted for policymakers, researchers, clinicians, administrators, and community leaders who seek information to improve health care services for all Americans: Disparities remain prevalent; Some disparities are diminishing while others are increasing; Opportunities for reducing disparities remain; Information about disparities is improving, but gaps still exist.