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Data may suggest narrowing of ethnic disparities


A report in The New England Journal of Medicine suggests that hospital may be making more progress than many had believed in reducing disparities among minorities in healthcare.

Between 2005 and 2010, disparities in care between white  and black patients fell for 13 of the 17 Centers for Medicare & Medicaid Services inpatient process measures. Those between white and Hispanics fell for 14 of the measures.

“But don’t get too excited,” says Hospitals & Health Networks. ”The results are not conclusive evidence that actual care is improving, says Marilyn Lynk, director of operations for Adventist HealthCare’s Center for Health Equity and Wellness. Outcomes measures would offer a better representation, and history indicates that improvement is still needed in reducing disparities found in outcomes data, Lynk says. There have been general findings that minorities are less than satisfied regarding communication with providers. It will vary widely by hospital, she says.”

”Lynk suggests that hospitals study their own data for signs of disparities in their care, a job that should be getting easier with the use of electronic health records.”


New ambulatory vs. critical-care confusions


A look at the usefulness and reality of new federal quality and safety benchmarks this year, which are not leaving everyone happy.

Consider that, as Hospitals & Health Networks reports, a “major shift is taking place in Medicare’s Physician Quality Reporting System program, while the National Quality Forum is examining a group of relatively unpopular patient-safety measures for possible revision.”

”{S}ome physicians — including specialists who work in ambulatory care — continue to be concerned that they will have a difficult time finding measures that realistically can be met.

”Some of the worry is driven by changes to the measures that can be used in PQRS reporting. Emergency department physicians face a limited number of choices that can be applied to their specialty. ”

H&HN said that Catherine Polera, chief medical officer for the emergency medicine division of Sheridan Healthcare, noted that ”the Centers for Medicare & Medicaid Services removed some of the core measures that may have worked in an emergency department setting and replaced them with ambulatory care measures. The new measures ‘relate more to primary care than they do critical care.’

”Although primary-care measures have some application to the ED, ‘we see more trauma, we see more chest pain patients, more abdominal pain patients, and I’m not seeing those related measures,’ she says.”

‘”Determining the implications for a hospital is a little more complicated,” Akin Demehin, senior associate director of policy for the American Hospital Association (AHA), told H&HN {which is part of the AHA}. “‘It mainly boils down to whether a physician bills for the procedure or whether the hospital bills for the physician. Whoever submits the bill, generally speaking, is going to be responsible for the reporting.”’



CMS details ‘Triple Aim’ progress


The Centers for Medicare & Medicaid Services  detailhow the healthcare system has made “clear progress” toward the “Triple Aim” of improved care, improved health and reduced costs.


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