Despite heightened attention paid to patient safety issues in recent years, the quality of health care across the country is improving slowly. Although incremental gains have been made, the United States overall, and California in particular, are still grappling with questions of quality.

Published as part of CHCF's California Health Care Almanac, this year's Quality of Care Facts and Figures is divided into two presentations: one focuses on clinical areas and the other on settings of care.

Quality of care by clinical area reveals strong statewide performance on some childbirth-related measures, and cancer incidence and mortality, but difficulty with ensuring consistent quality across racial and ethnic groups. Key findings include:

• In California and the United States, rising rates of delivery by cesarean section and maternal mortality are raising concerns about the quality of care delivered to pregnant women.
• Significant racial and ethnic disparities persist for maternal and infant mortality, with much higher mortality rates being reported for African American mothers and infants than for Whites, Latinos, and Asians.
• Disparities also exist in the rates of potentially preventable admissions for pediatric asthma, diabetes, and congestive heart failure.

Quality of care by setting reveals strong statewide performance on home health care. Key findings include:

• California's statewide attention to patient safety brings to light problems with pressure ulcers and retention of foreign objects in patients.
• California hospitals have improved their performance on recommended process-of-care measures for surgical, heart attack, heart failure, and pneumonia inpatients.
• Despite improving their performance, California nursing homes continue to perform worse than the nation on the use of physical constraints.

The complete presentations are available under Document Downloads.