As the United States devotes extensive resources to health care, evaluating how successfully the U.S. system delivers high-quality, high-value care in an equitable manner is essential. At the request of Congress, the Agency for Healthcare Research and Quality (AHRQ) annually produces the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). The reports have revealed areas in which health care performance has improved over time, but they also have identified major shortcomings. After five years of producing the NHQR and NHDR, AHRQ asked the IOM for guidance on how to improve the next generation of reports.



The IOM concludes that the NHQR and NHDR can be improved in ways that would make them more influential in promoting change in the health care system. In addition to being sources of data on past trends, the national healthcare reports can provide more detailed insights into current performance, establish the value of closing gaps in quality and equity, and project the time required to bridge those gaps at the current pace of improvement.


Table of Contents


Front Matter
Summary
1 Introduction
2 Re-Envisioning the NHQR and NHDR
3 Updating the Framework for the NHQR and NHDR
4 Adopting a More Quantitative and Transparent Measure Selection
Process
5 Enhancing Data Resources
6 Improving Presentation of Information
7 Implementing Recommended Changes
Acronyms
Appendix A: Previous IOM Recommendations for the National
Healthcare Reports
Appendix B: Key Findings of the NHQRs and NHDRs
Appendix C: Previous Conceptual Framework
Appendix D: Measurement Opportunities for the Framework's
Components of Quality Care
Appendix E: HHS Interagency Workgroup for the NHQR and NHDR
Appendix F: The Expected Population Value of Quality Indicator
Reporting (EPV-QIR): A Framework for Prioritizing Healthcare
Performance Measurement
Appendix G: IOM Subcommittee on Standardized Collection of
Race/Ethnicity Data for Healthcare Quality Improvement:
Recommendations
Appendix H: Additional Assessments of Data Presentation in the NHQR
and NHDR
Appendix I: An Illustrative Funding Example
Appendix J: Committee Member and Staff Biographies