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Notably, several of the major limitations we have discussed here also apply to measures included in AHRQ's NHQR effort.
First, we wanted to examine multiyear trends in annual incidence rates for the PSIs, which AHRQ had not reported in the NHQRs. Second, to explore the robustness of PSI estimation methodology, we sought to develop independent PSI estimates that replicated AHRQ's estimates, before analyzing time trends.
Similar to results reported in the NHQRs, we generally observe that recent historical trends in national safety outcomes have been mixed: Some adverse outcomes have become more frequent over time, others less so, while still others appear to have remained fairly stable.
Both our own work, and the NHQRs, have been limited in this regard: New data resources and measurements covering ambulatory and long-term care settings are strongly needed.
For those of you who are new to these reports, a little background: the NHQR and NHDR are congressionally mandated reports that have been produced by AHRQ since 2003.
Relative to the 2005 NHQR, a greater percentage of measures moved from the "no significant change" category into the "improvement" category.
Variation in health care quality remains high: The NHQR collects data on health care quality for States and uses maps to present some of the data.
In addition to increasing the breadth and granularity of the NHQR and NHDR, we have also improved how they can be used by creating better web tools with increased access to data and graphs and presenting future reports in a new format that will allow us to go deeper into the measures.
The NHQR and the NHDR are the only reports that track the nation's progress each year in improving health care quality and reducing health care disparities across a broad range of conditions, services, and population groups.
The NHQR presents the broadest examination ever undertaken of the quality of health care in the U.S.
Health care quality continues to improve at a modest pace across most quality measures: The median rate of annual change for the 44 core measures is a 2.8 percent improvement--the same rate of improvement as reported in the 2004 NHQR. Of 44 core categories, slightly over half (23 or 52 percent) improved.
The issues--like the NHQR and NHD--are closely related.
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