2020 Edition — Quality of Care: Providers

Jen Joynt, Independent Health Care Consultant


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Over the last few decades, there has been significant growth in the measurement and reporting of health care quality outcomes. As health care evolves, it is important to continue to monitor and report on the quality of care delivered to patients in California and across the US. This is part of a series of measures CHCF is publishing on the quality of care in our state. Topics range from maternal to end-of-life care, and include measures on behavioral health, chronic conditions, and providers.

This set of quality measures focuses on providers, including ambulatory surgery centers, emergency departments, inpatient hospitals, nursing homes, home health care, and hospice.

California’s ambulatory surgery centers report low patient-safety error rates.

In both California and the US, ambulatory surgery centers report low error rates on four quality measures related to high-priority patient safety issues for Medicare. Lower rates are better. For all these measures, California performs similarly to or better than the US overall.

California patients spend more time in emergency departments than patients nationwide.

Patients visiting California emergency departments (EDs) have longer lengths of stay than patients nationwide — especially patients who are admitted to the hospital from the ED. In California, these patients spend over an hour longer in the ED than do their counterparts nationwide.

Hospital readmission rates vary by race/ethnicity and by payer.

In 2017, 19% of Black Californians were readmitted to the hospital within 30 days compared to 15% of Latino, and 14% of Asian and white Californians. Readmission rates also varied by payer, with about 16% of Medicare and Medi-Cal patients readmitted within 30 days, compared to 11% of patients with private insurance.

One in nine California nursing home residents received an antipsychotic medication in 2018.

While antipsychotic medications are an important treatment for patients with certain mental health conditions, the FDA has warned that antipsychotic drugs are associated with an increased risk of death when used in elderly patients with dementia. Since 2013, the percentage of California nursing home residents receiving antipsychotic medications decreased from 16.5% to 11%.

The companion Excel data files are available for download below. These materials are part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape. See our entire collection of current and past editions of Quality of Care.