Balancing the nation's health care scorecard: the National Healthcare Quality and Disparities Reports

Abstract

Background: In January 2005, the U.S. Agency for Healthcare Research and Quality (AHRQ) released the congressionally mandated reports on the United States health care system--the 2004 National Healthcare Quality and Disparities Reports (NHQR and NHDR). They are intended to summarize the current state of the science of health care quality and disparities for a broad audience, including providers, consumers, researchers, and policy makers.

Balancing the health care scorecards: The NHQR and NHDR are designed as balanced scorecards, yet measure imbalance is evident with respect to relative attention to the quality dimensions, condition/clinical areas, and priority population. For example, heart disease and nursing home/home health each represent more than 20 measures of the total of 179 measures, whereas mental health and HIV/AIDS care are tracked with a total of six.

Using the scorecard for quality improvement (qi): The measures making up the scorecards are derived directly from current national initiatives aimed at improving specific performance measures in hospitals, nursing homes, and home health agencies, which facilitates performance benchmarking at different levels of the health care system.

Conclusion: Much work remains to be done if these reports are to be used to their fullest potential as balanced scorecards for the United States.