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National Healthcare Disparities Report


In its reauthorization legislation, Congress mandated that the Agency for Healthcare Research and Quality (AHRQ) produce an annual report on health care disparities in the United States (Public Law 106-129). The National Healthcare Disparities Report (NHDR) will include a broad set of performance measures that will be used to monitor the Nation's progress toward improved health care quality for all Americans.

Select for Preliminary Measure Set, Comment, NHDR Fact Sheet.


Organizations Involved
Conceptual Framework
Comments on Preliminary Measures
More Information
How to Provide Comments

Organizations Involved

Many organizations worked with AHRQ to help develop the measure set, conceptual framework, and products for the first National Healthcare Disparities Report (NHDR).   These groups include:

NHDR Data Group

AHRQ formed the NHDR Data Group, an internal committee comprised of staff with expertise in health care disparities and data analysis.  In its weekly meetings, these staff members have focused on:

The NHDR Interagency Workgroup

The NHDR Interagency Workgroup of the Department of Health and Human Services (HHS) includes representatives from:

This group, in its monthly meetings, has provided invaluable advice and comments on draft definitions and measures, and identified new data sources and measures for inclusion in the NHDR. 

IOM's Committee on Guidance for Designing a NHDR

AHRQ contracted with the Institute of Medicine (IOM) to provide guidance for the NHDR. The IOM formed the Committee on Guidance for Designing a NHDR, which was comprised of 13 leading experts in health care disparities from across the country. 

Chaired by Dr. Sheldon Greenfield, the committee commissioned papers, held public meetings, and heard testimony from a wide variety of groups including:

The IOM committee's recommendations were published in Guidance for the National Healthcare Disparities Report in September 2002.  For more information, go to the IOM's Disparities Web site.

NHQR Staff

Because high quality care is critical to eliminating healthcare disparities, the NHDR benefited greatly from the work being done on the National Healthcare Quality Report by AHRQ staff.  AHRQ also acknowledges the work conducted by members of NHQR's Interagency Workgroup.  In addition to measures of access to care, cost, and utilization, the NHDR will include all of the quality measures chosen for inclusion in the NHQR (e.g., indicators of safety, effectiveness, patient-centeredness, timeliness, and equity).

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Conceptual Framework

The NHDR will build on the conceptual framework that the IOM developed for AHRQ's congressionally-mandated National Healthcare Quality Report.  This framework can be visualized as a matrix, relating dimensions of care (e.g., access, utilization, cost, and quality) to patient needs (e.g., staying healthy, getting better, living with illness or disability, coping with the end of life).

Select for Conceptual Framework (66 KB).

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Comments on Preliminary Measures

In addition to the NHQR measures, AHRQ staff have explored data and measures from a wide variety of sources.  AHRQ also reviewed and accepted suggestions for possible databases and specific measures that were submitted by the public in response to a Federal Register notice published on June 5, 2002. 

Now AHRQ is seeking input on the preliminary measure set from stakeholders and other interested parties. Anyone interested in the NHDR may provide comments to AHRQ.  The agency is especially interested in input on the individual measures included and the overall balance, comprehensiveness, and robustness of the measure set. Select for details on providing comments.

While obtaining input, AHRQ will begin relevant data analysis for the measures in the preliminary measure set. Based on the input and the results of analyses, final decisions will be made on which measures will be included in the first NHDR. AHRQ hopes to obtain agreement on the final measure set by January 1, 2003. This decisionmaking process will involve broad input from throughout HHS.

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More Information

Multiple Reporting Products

AHRQ is currently conducting audience research to identify the needs of potential audiences in an effort to develop a final product that meets those needs.   Findings to date indicate two main audience groups:

The report to Congress will be designed to meet the needs of both audiences. It will include a short summary report that highlights the key points from the analysis (for the policy audience) and appendixes that include technical specifications and detailed tables for all of the measures (for the analyst audience). All appendixes will be available on the AHRQ Web site. 

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How to Provide Comments

AHRQ requests your input on the preliminary measure set. Please make comments or suggestions by December 13, 2002, to:

Helen Burstin, M.D.
Director, Center for Primary Care Research
Agency for Healthcare Research and Quality
Phone: (301) 427-1500
E-mail: NHDR@AHRQ.gov

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Current as of November 2002

Internet Citation:

National Healthcare Disparities Report. Background. November 2002. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/nhdr02/nhdrprelim.htm

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