According to the sixth annual National Healthcare Quality Report (NHQR) from the Agency for Healthcare Research and Quality (AHRQ), many Americans aren't receiving the care they need. The AHRQ report collects data on health care quality from across the country and analyzes it using indictors from four important categories: effectiveness, patient safety, timeliness, and patient centeredness.

The NHQR turned up three main themes:

Health care quality is suboptimal and continues to improve at a slow pace. Out of the 45 core measures of health care quality used in the report, an average of only 59 percent of Americans were receiving the total amount of recommended care for their health needs. For example, a heart transplant patient might receive up to 95 percent of the medical services they need to achieve the best possible outcome, while in contrast, a patient on dialysis only has about a 15 percent chance of being placed on a kidney transplant waiting list.

Reporting hospital quality is leading to improvement, but patient safety is lagging. Across the 220 measures of quality in the report (including the 45 core measures mentioned above) 69 percent showed some indication of improvement. However, this improvement was very small—the average rate of change for all measures was only 1.4 percent. Over the past six years, patient safety measures such as the rate of hospital acquired infections (HAIs) have grown worse by almost one percent. Health and Human Services Secretary Kathleen Sebelius spoke out against the shortcomings in patient safety and health care quality last week, and announced that 50 million dollars from the American Recovery and Reinvestment Act would go towards fighting HAIs.

Health care quality measurement is evolving, but much work remains. There is no standard source for the data that the AHRQ analyzed in this report—instead, they worked with numerous data elements from different times and different populations. Though the U.S. health care system has attempted to become more proactive in terms of prevention, wellness, and chronic care management, the system is still performing far better in the reactive areas of diagnostic, therapeutic, and rehabilitative care. For example, 66 percent of the measures related to the treatment of acute medical problems showed the high levels of improvement.

As the report points out, reports by themselves are not going to fix the health care system. Health care providers, policymakers, industry stakeholders, and others need to think critically about the problems facing our health care system and work together to come up with solutions. The high quality care that Americans deserve, but are not yet getting consistently, is one key component of health care reform.

"Today's reports show why we can't wait to enact comprehensive health reform," said HHS Secretary Sebelius in a press release. "The status quo is unsustainable and we cannot allow millions of Americans to continue to go without the care they need and deserve."