Quality of Care: Signals of Change

By Jen Joynt

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.

 A horizontal bar chart titled "Hospitals Deaths from Heart Conditions and Procedures."
 

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

A horizontal bar chart titled "Diabetes Admission Rates by Ethnicity in California."
 

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

A chart titled "Maternal Mortality Rates by Race/Ethnicity."
 

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

A chart titled "Cesarean Deliveries."
 

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.

A horizontal bar chart titled "Nursing Home Quality Measures with Good Performance."
 

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.

A horizontal bar chart titled "Home Health Measures With Good Performance."
 

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.

A bar chart titled "Deaths Occurring in Hospital Medicare Patients."

 

Further data and analysis on this topic is available from the Agency for Healthcare Research and Quality, the Centers for Medicare & Medicaid Services, the Dartmouth Atlas of Health Care, and Medicare.gov.

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