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The sixth annual National Healthcare Quality Report from the Agency for Healthcare Research and Quality (AHRQ) finds that the quality of care provided by the U.S. health care system continues to improve at a slow pace, but many Americans still do not receive recommended care, AHA News Now reports. The congressionally-mandated analysis tracks trends in health system performance on 45 core measures of the effectiveness, safety, timeliness and patient focus of care. According to the report, the median annual rate of change for all quality measures was 1.4 percent, while the median level of receipt of needed care was 59 percent across the core measures. Measuring improvement across prevention, acute care and chronic care management categories, the AHRQ found that acute treatment measures showed the strongest rate of quality improvement, with 66 percent exhibiting some gains. However, the report indicates that patient safety measures worsened by nearly 1 percent per year during the past six years. Meanwhile, quality improvements continued to be spread unevenly across health care settings. For instance, care delivered in hospitals improved at an annual rate of change of nearly 3 percent, while care provided in ambulatory care settings improved at a rate that only slightly exceeded 1 percent. Commenting on the report's findings, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius urged providers to work harder at reducing health care-associated infections and announced the availability of $50 million in federal stimulus grants to help facilities meet this challenge. Specifically, HHS will allocate $40 million to create or expand state infection and surveillance programs and $10 million to improve processes and increase ambulatory surgical center inspections. Noting that the report demonstrates why the country "can't wait to enact comprehensive health reform," Sebelius, who was speaking at the United Nurses of America's National Nurses Congress, added, "the status quo is unsustainable." (AHA News Now, 5/6/09; AHRQ report, March 2009; AHRQ release, 5/6/09; Goedert, Health Data Management, 5/6/09)