0
Commentary |

Equality-in-Quality in the Era of the Affordable Care Act

Matthew M. Davis, MD, MAPP; Jennifer K. Walter, MD, PhD
JAMA. 2011;306(8):872-873. doi:10.1001/jama.2011.1208.
Text Size: A A A
Published online

Extract

Health care received by patients in the United States is of inadequate quality.1 As part of the federal response to this major shortcoming, ensuring high-quality health care is a central theme throughout the Patient Protection and Affordable Care Act (ACA) signed into law in 2010.

The focus on improving quality in the ACA, however, effectively overshadows other major concerns about the US health care system—among them, pervasive and persistent disparities in health care related to factors such as sex, race/ethnicity, social class, insurance status, and language that fundamentally constrain how much overall quality can improve. The comparative inattention in the ACA to known inequalities in health care is noteworthy, not only in comparison with the focus on quality, but also because the lack of emphasis on disparities in the ACA language is inconsistent with recent positions of the Agency for Healthcare Research and Quality (AHRQ)2 and the Institute of Medicine (IOM).3 The AHRQ and IOM have indicated that reducing disparities is an unambiguous priority in working to improve quality in health care.13 This approach is consistent with analyses suggesting that reducing disparities based on social factors may improve health care quality more than would marginal improvements in overall medical care.4

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 4

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();