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Since 2003, the Agency for Healthcare Research and Quality (AHRQ), together with its partners in the Department of Health and Human Services (HHS), has reported on progress and opportunities for improving health care quality. With this fifth annual National Healthcare Quality Report (NHQR), these reports will have provided more than 50,000 data points about health care quality in the United States. Has it made a difference? Have Federal and State governmental agencies, provider organizations, insurers, and employers made progress in improving health care quality and safety? While every previous release of the NHQR has attempted to summarize the direction in which health care quality is going, this fifth report tries to summarize the progress that has been made and the remaining challenges to improve health care quality in this Nation. The NHQR is built on 218 measures categorized across four dimensions of quality—effectiveness, patient safety, timeliness, and patient centeredness. This year’s report focuses on the state of health care quality for a group of 41 core report measures that represent the most important and scientifically credible measures of quality for the Nation, as selected by the HHS Interagency Work Group.