Understanding Healthcare Quality

October 19, 2020


Stephanie Goraczkowski


Healthcare Quality Week is a week dedicated to celebrating the involvement of healthcare professionals in their role to improve the quality of healthcare, and to bring awareness to new challenges and opportunities in the field going forward. During the pandemic, healthcare quality has become a front and center conversation as more healthcare professionals are urged to make it a vital part of their work.


Understanding Healthcare Quality


How has “quality” healthcare been defined?

Don Berwick, MD, MPP, Former President and CEO of the Institute for Healthcare Improvement describes six points of quality in healthcare: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. These are marked as the key areas for healthcare to maintain and improve upon.

Providing safety in quality healthcare is defined as reducing hazards and risks in a healthcare environment as it relates to patients. Simply enough, keep patients safe. The cornerstone effectiveness is matching science to healthcare in order to avoid overusing care that doesn’t help patients and continue to use the things that do help patient wellness. Quality healthcare means people should be in control of their own healthcare. Healthcare professionals should put patients at the center of their own healthcare, i.e. – patient-centeredness. Timeliness is important to avoid needless healthcare delays so patients can get the best care as soon as possible. Efficiency is shown in avoiding healthcare waste, in avoiding record loss and being effective with healthcare resources.

The focal point of healthcare quality has been in equity. Closing the gap in justice in healthcare and understanding inequities help facilitate change. This point has been arguably the pinnacle of healthcare quality lately.

The annual National Healthcare Quality and Disparities Report is a Congress-mandated overview of the quality of healthcare received by the U.S. population and the comprehensive discrepancies in healthcare that are experienced by different racial and socioeconomic groups.


Healthcare quality as it relates to wealth

Studies show that the higher one’s income, the lower one’s probability of disease and poor health. Not only are income and earnings associated with better health, but one’s acquired wealth, net worth and assets affect health as well.

Income and wealth are also associated with mental health. In a report from CDC, people with household incomes below $35,000 are four times more likely to report nervousness and stress and five times more likely to report frequent sadness than people with families who earn more than $100,000 each year.


Reasons for healthcare inequality

There are six main reasons why lower-income households have poor health.


Sickness is more likely in lower-income families

There have been numerous studies and links to the impact of socioeconomic on health and some researchers state that socioeconomic status could be one of the most decisive points that affects a person’s health and life expectancy. This socioeconomic impact is poignant in three categories of a person’s life: their occupation, their income, and their education. One study found that a quarter of low-income families have poor health compared to 15 percent of the wealthy families.


Poverty and poor health are a vicious cycle

Not only is poverty linked to poor health outcomes, but those with poor health are likely to end up in poverty. It’s simply harder to find and maintain a higher-paying job when you are chronically ill.


We have an aging, unwell population

The elderly population is more likely to be ill and poor. According to a Kaiser Family Foundation (KFF) poll, half of those on Medicare in 2016 had an income of less than $26,200 annually, while nearly 10 percent of them lived in poverty. Those numbers have only increased the last four years.


Healthcare costs are rising

One in five low-income Americans said they went without care because they couldn't afford it. Only one out of 25 high-income families said the same thing. Without treatment, the poor sick get sicker until they wind up in the emergency room

The rising cost of healthcare can push people into poverty. In a 2018 study, 7 million people were placed below the poverty line dues to rising medical expenses. When medical bills pile up, healthcare debt collection comes into play, making it even harder to tread financial water. In 2015, 1 million people declared medical bankruptcy.


Lack of access to health services and technology

Low-income families live in low-income neighborhoods, which lack access to the best quality hospitals, clinics and medical facilities with the most up-to-date technology, especially in rural areas of the U.S.


Lack of access to quality health insurance

According to a 2015 Kaiser Family Health survey in 2015, the average deductible in employer-sponsored health plans rose 255 percent in 12 years. This increase also applies to deductibles and copays and comes from a combination of health insurance companies increasing medical costs for people, while some employers reduced their share of pitching in on healthcare.

Additionally, several of the working poor don't qualify for Medicaid and support that can be received under the current government health plan is limited in the hospitals and doctors it covers.


Healthcare quality matters

Quality of care is vital. All of this can help healthcare providers offer reliable, cost-effective and long-term plans to enhance patient outcomes. The bottom line is: healthcare quality reduces mortality rate. Providing equity in healthcare, improving the quality of care given and helping enhance the performance of healthcare professionals means happier, healthier and sustainable public health.

Additionally, NAHQ has several free live and on demand resources that are available to NAHQ members, healthcare leaders and healthcare professionals through their website.

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