Quality of Care: Signals of Change

Jennifer Joynt

Over the last few years, the quality of health care in California has improved on a number of measures. However, significant racial and ethnic disparities persist in some areas.

November 2014

From birth to death, the quality of health care being delivered in California has improved on several important measures in recent years. But significant racial and ethnic disparities persist, particularly for infant and maternal mortality.

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 mental health care, patient safety, nursing homes, home health, and end-of-life care.

Key findings include:



California hospitals showed improvement in the timely and effective delivery of care for heart attack and heart failure patients. Inpatient mortality rates for several heart-related conditions and procedures were cut in half.

Hospital Deaths from Heart Conditions and Procedures, California, 2000 and 2010


Racial disparities persisted in hospital admissions for diabetes and heart patients.

Diabetes Admission Rates, by Race/Ethnicity, California, 2012


Maternal mortality rates declined overall, but rates for African American women were still significantly higher than for other racial/ethnic groups.

Maternal Mortality Rates, by Race/Ethnicity, California, 2000 to 2012


Cesarean section rates remained stable since 2009 after rising for a decade.

Cesarean Deliveries, California vs. United States, 1997 to 2012


Compared to the United States, California's nursing homes performed better on a number of measures, including weight loss, depression, and preventing falls but performed worse on the physical restraint of patients.

Nursing Home Quality Measures with Good Performance, California vs. United States, 2013


California home health agencies performed better than the nation on some measures related to physical and mental health but were among the worst in improving activities of daily living.

Home Health Measures with Good Performance, California vs. United States, 2013


Medicare patients in California were more likely than those nationwide to die in a hospital and to have an ICU admission in the days preceding death.

Deaths Occurring in Hospital, Medicare Patients, California vs. United States, 2003 and 2011

The complete report and all the charts found in the report, as well as an earlier version, are available under Document Downloads.