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Quality of Care: Steps in the Right Direction

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Quality of Care: Steps in the Right Direction

Jennifer Joynt

A wide array of measures indicates improvements in the delivery of health care in California, but serious racial and ethnic disparities persist.

October 2013

From birth to death, the quality of health care being delivered in California has improved on a number of important measures in recent years. But significant racial and ethnic disparities persist, particularly for infant and maternal mortality, as well as for care of patients with heart disease, diabetes, or asthma.

Published as part of CHCF's California Health Care Almanac, this report looks at the quality of care in California on a variety of measures, including childbirth, children's health, and management of patients with common chronic conditions. It also provides data on patient safety, nursing homes, home health, and end-of-life care.

Key findings include:

  • After a 2005–2007 spike in deaths among African American women giving birth, the mortality rate has declined in recent years, but is still significantly higher than for all other racial groups.
  • The percentage of California children receiving recommended vaccines increased 13% from 2010 to 2011. The state performed better than the US in 2011.
  • African Americans fare worse than other races for potentially preventable emergency department visits for pediatric asthma and hospital admissions for diabetes and heart failure.
  • California hospitals have markedly improved in the timely and effective delivery of care for heart attack, heart failure, and surgery patients. Deaths from common heart conditions and procedures have declined significantly.
  • Nursing homes in California performed well on a number of measures compared to the US, including preventing falls, weight loss, and depression. However, California nursing home patients were more likely to be physically restrained than others in the US.
  • Compared to the nation as a whole, California Medicare beneficiaries at the end of life were more likely to die in a hospital and more likely to have an ICU admission in the days preceding death, even though surveys report that most terminally ill patients want to die at home.

The complete report, as well as the two-part 2012 edition, is available under Document Downloads.