Prepare a 3- to 5-page paper comparing and contrasting the measures of quality for each of the countries discussed in this module. Some of the measures you can discuss are morality, readmissions, safety of care, patient experience, effectiveness of care, timeliness of care, efficient use of medical care, and others.

Be sure to identify the features that constitute quality in these countries. What is preventing quality from being achieved and how can this be fixed?

Comparing and contrasting for Canada, Mexico, Peru, Brazil along with the United States

1 Measures of Quality Course name Johanna Laguerre Professor: Dr. Tracy Smith Thomas Edison State University Date: February 05, 2023 2 Overview The United States healthcare system is facing numerous challenges in terms of quality and accessibility. While the country has some of the best medical facilities and healthcare professionals, several factors contribute to inadequate quality of care. To assess the quality of care in the United States, various aspects must be considered, including morality, readmissions, the safety of care, patient experience, the effectiveness of care, timeliness of care, efficient use of medical care, and others. Morality in the United States healthcare system refers to the death rate of patients while undergoing medical treatment. According to the World Health Organization (WHO, 2021), the United States ranks 27th in terms of morality, which suggests that the quality of medical care in the country is not on par with the best in the world. This can be due to several factors, including a lack of access to medical care for certain populations, a fragmented healthcare system, and higher costs of care compared to other developed nations. Additionally, disparities in healthcare quality between racial and ethnic groups have been well documented (Smedley et al., 2002). For example, African Americans have higher mortality rates for many illnesses compared to non-Hispanic whites, despite having similar access to medical care (Smedley et al., 2002). This disparity highlights the need for targeted efforts to improve the quality of care for minority populations in the United States. Studies have shown that readmissions remain a significant problem in the U.S. healthcare system. According to the Agency for Healthcare Research and Quality (AHRQ), approximately 20% of Medicare beneficiaries are readmitted within 30 days of their initial discharge from the hospital (AHRQ, 2021). This high rate of readmissions contributes to increased healthcare costs and reduced quality of life for patients. 3 The safety of healthcare in the United States is a complex and multifaceted issue. While the country has some of the world’s leading medical facilities and highly trained healthcare providers, the overall safety of care has been criticized and is a subject of ongoing improvement efforts. There are concerns about medical errors, patient harm, infections, and medication-related adverse events. Additionally, disparities in access to quality healthcare persist, leading to unequal health outcomes for certain populations. Efforts to improve patient safety and reduce harm in healthcare settings include increased patient involvement in their care, increased transparency in reporting and analyzing medical errors, and the adoption of evidence-based practices and technologies. Studies have shown that patient safety remains a major concern in the U.S. healthcare system. According to the National Patient Safety Foundation (NPSF), medical errors are estimated to occur in 1 out of every 10 hospital admissions (NPSF, 2021). This high rate of medical errors can lead to adverse events such as harm, injury, or death. Patient experience in the United States varies greatly depending on many factors, including access to healthcare, insurance coverage, and personal circumstances. However, some common issues affecting the patient experience include long wait times, difficulty communicating with healthcare providers, and a perceived lack of empathy or personalized attention. There is also evidence of racial and socioeconomic disparities in healthcare experiences, with marginalized communities often reporting poorer experiences and lower satisfaction with their care. The effectiveness of healthcare in the United States is a complex issue that has received significant attention from researchers and policymakers. The U.S. healthcare system lags behind other countries in terms of access to care, patient safety, and coordination of care, among other measures of healthcare quality (Schoen et al., 2019). The findings of this report highlight the 4 need for continued improvement in the U.S. healthcare system. Despite the country’s significant investment in healthcare, patients still face significant barriers to receiving high-quality, effective care, including long wait times, difficulty coordinating care among multiple providers, and disparities in access to care based on race, ethnicity, and income. The timeliness of care in the United States is an important aspect of the overall quality of healthcare, as patients expect to receive care on time that meets their needs. However, recent studies have found that wait times for medical appointments and procedures can be significant in some areas of the country. For example, a study conducted by the Agency for Healthcare Research and Quality (AHRQ) found that over one-third of primary care patients in the United States reported wait times of over 20 minutes to see a doctor, and nearly one in five reported wait times of over 30 minutes (AHRQ, 2020). The study also found disparities in wait times based on insurance status, with uninsured patients reporting longer wait times compared to those with insurance. The efficient use of medical care, which refers to the effective and appropriate use of resources in delivering healthcare services, is an ongoing challenge in the United States. Despite being one of the world’s largest healthcare markets, the country continues to grapple with high healthcare costs and widespread waste in the system. A recent report from the Institute of Medicine (IOM) estimated that approximately 30% of healthcare spending in the United States is wasted, largely due to inefficiencies in care delivery and overuse of medical services (IOM, 2012). The quality of care in the United States is prevented from reaching its full potential due to a complex and interconnected set of factors, including: 5 ● Access to care: Despite significant investment in healthcare, many Americans still face barriers to accessing care, particularly those from low-income and marginalized communities (Kaiser Family Foundation, 2019). ● Cost: High healthcare costs can prevent patients from receiving the care they need, and also contribute to waste in the system. “The U.S. spent nearly 18% of its Gross Domestic Product on healthcare in 2016, a higher share than in any other country” (OECD, 2017). ● Provider shortages: In some areas of the country, there are shortages of healthcare providers, which can lead to long wait times and difficulty accessing care. “Rural areas in particular face provider shortages, with approximately 20% of rural populations living in areas with a shortage of primary care providers” (National Rural Health Association, 2020). ● Disparities in care: Significant disparities in the quality of care received by different populations, particularly those based on race, ethnicity, and income, persist in the United States. “Black Americans, for example, are more likely to experience disparities in care, including lower rates of access to care and higher rates of chronic conditions” (National Academy of Medicine, 2019). ● Fragmented care: Inadequate coordination of care between providers and across the healthcare system can lead to duplicative tests, procedures, and treatments, and can impact the overall quality of care received by patients (Institute of Medicine, 2011). To fix the quality of care in the United States, several measures can be taken: ● Increasing access to care: This can include expanding insurance coverage, increasing funding for community health centers, and addressing provider shortages. 6 ● Containing costs: Efforts to reduce waste and inefficiencies in the healthcare system can help to contain costs, while still ensuring that patients receive high-quality care (Harvard Institute, 2018). ● Addressing disparities in care: Addressing disparities in the quality of care received by different populations can improve the overall quality of care in the United States (National Academy of Medicine, 2019). ● Improving coordination of care: Efforts to improve care coordination, such as through the use of health information technology, can help to reduce duplicative tests, procedures, and treatments and improve the overall quality of care received by patients(Agency for Healthcare Research and Quality, 2018). ● Investing in quality improvement: Ongoing investments in quality improvement initiatives and research can help to identify best practices and promote continuous improvement in the quality of healthcare in the United States (Harvest Institute, 2018). 7 References: Agency for Healthcare Research and Quality (2018). Health Information Technology (IT) and Patient Safety. https://www.ahrq.gov/patients-consumers/diagnosis-treatment/healthinformation-technology/index.html. Agency for Healthcare Research and Quality. (2020). Timeliness of Care. https://www.ahrq.gov/patient-centered/patient-involvement/timeliness-of-care/index.html AHRQ. (2021). Readmissions. Agency for Healthcare Research and Quality. https://www.ahrq.gov/patient-safety/settings/hospital/quality/readmissions.html. Harvest Institute (2018). Improving Efficiency in the Healthcare System. https://www.harvestinstitute.org/research-programs/healthcare-efficiency Institute of Medicine (2011). Improving the Quality of Health Care for Mental and Substance-Use Conditions. https://www.ncbi.nlm.nih.gov/books/NBK83612/ Jha, A. K., Orav, E. J., & Epstein, A. M. (2013). Hospital quality and readmissions. JAMA, 309(17), 1813-1814. https://doi.org/10.1001/jama.2013.2716 Kaiser Family Foundation (2019). Nearly 30 Million People Remain Uninsured in 2018. https://www.kff.org/uninsured/fact-sheet/nearly-30-million-people-remain-uninsured-in-2 018/ OECD (2017). Health spending per capita (indicator). doi: 10.1787/aec5b0da-en (Accessed on 2023-02-05) National Rural Health Association (2020). Provider Shortages in Rural America. https://www.ruralhealthweb.org/policy-advocacy/provider-shortages-in-rural-america National Academy of Medicine (2019). Health and Healthcare Disparities in the United States. https://nam.edu/initiatives/health-and-healthcare-disparities-in-the-united-states/ 8 NPSF. (2021). Patient Safety. National Patient Safety Foundation. https://www.npsf.org/patient-safety/. Smedley, B. D., Stith, A. Y., & Nelson, A. R. (2002). Unequal treatment: Confronting racial and ethnic disparities in health care. National Academies Press. Schoen, C., Collins, S. R., Lissauer, D., Rechtsteiner, E. A., Kriss, J. L., Doty, M. M., & Emerson, J. (2019). Mirror, Mirror 2019: A Summary of Findings on the State of Health Care Quality. Commonwealth Fund. https://doi.org/10.26099/j9dj-8f89. World Health Organization. (2021). Mortality. Retrieved from https://www.who.int/news-room/fact-sheets/item/mortality.