AHRQ's 2007 State Snapshots Provide Broader Portraits Of State-By-State Health Care Performance

Main Category: Public Health
Article Date: 27 Mar 2008 - 2:00 PDT

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An annual analysis to help health leaders identify areas of health care delivery that need quality improvement now includes important information such as each state's rate of obesity, health insurance coverage, mental illness and the number of specialist doctors.

Those and other measures - called "state contextual factors" - are part of the 2007 State Snapshots released by the federal Agency for Healthcare Research and Quality. The updated State Snapshots Web tool also tracks states' progress toward reaching government-set health goals for 2010.

"This year's State Snapshots do more than illustrate the wide variations in health care quality among states," said AHRQ Director Carolyn M. Clancy, M.D. "They also show a handful of the important challenges that states face as they work to improve the quality of care."

As in previous years, the 51 State Snapshots - every state plus Washington, D.C. - summarize health care quality in three dimensions: type of care (such as preventive, acute or chronic care), setting of care (such as nursing homes or hospitals), and by clinical areas (such as care for patients with cancer or diabetes). The evaluations are expressed in simple, five-color "performance meter" illustrations that rate performance from "very weak" to "very strong." Users may explore whether a state has improved or worsened compared to other states in several areas of health care delivery.

Users can get more detailed portraits of each state's performance by exploring the State Snapshots' 149 separate measures of quality. Those measures range from preventing pressure sores to screening for diabetes-related foot problems to giving recommended care to pneumonia patients.

Finally, the State Snapshots provide state rankings for 15 "selected measures." These rankings show that no state does well or poorly in all areas. Texas, for example, ranked 4th best at minimizing nursing home patients' pressure sores but 41st on vaccinating older people against pneumonia. Ohio ranked 7th for its high percentage of pregnant women who received prenatal care but 46th for its high rate of breast cancer deaths. New Mexico ranked 4th best on improving the mobility of nursing home residents but 50th for its low number of heart attack patients who received the right medications at hospital discharge.

The data in this year's State Snapshots are drawn from the 2007 National Healthcare Quality Report. That report, released March 3 and available at http://www.ahrq.gov/qual/qrdr07.htm, provides a national portrait of health care quality. It showed the quality of health care improved by an average 2.3 percent a year between 1994 and 2005, a rate that reflects some important advances but points to an overall slowing in quality gains.

Highlights of the include:

- State Contextual Factors: This new feature provides demographics that show what percentage of each state is poor, uninsured, enrolled in Medicaid, age 65 or older, black, Hispanic and lacking a college degree. It also provides health information showing what portion of each state's population is overweight, at risk for stroke and heart disease or reports poor mental health. Lastly, this feature shows how states rank when it comes to hospitalization rates, the number of people enrolled in HMOs and the number of available physician specialists.

- Focus on Healthy People 2010: This new feature shows each state's progress toward meeting federal health goals established by the Healthy People 2010 initiative. Charts show how close states have come to reaching two dozen goals ranging from lowering the number of lung cancer deaths to increasing the percentage of people who had their cholesterol checked in the past 5 years.

- State Rankings for Selected Measures: This section updates state rankings on 15 important quality measures, such as child vaccination rates, breast cancer death rates, the percentage of nursing home patients improving mobility and the portion of Medicare patients who received clear and respectful advice from their doctor.

- Focus on Diabetes: This section offers several evaluations of diabetes care, including what portion of diabetes patients get recommended tests and how many patients are hospitalized for diabetes-related complications. The feature also estimates how much money each state might save by lowering average blood sugar levels.

- Focus on Clinical Preventive Services: This feature shows how each state is doing on disease-prevention strategies, such as providing pneumonia or flu vaccines, checking cholesterol levels or advising smokers to quit.

AHRQ's annual State Snapshots is based on data drawn from more than 30 sources, including government surveys, health care facilities and health care organizations. To access this year's State Snapshots tool, go to http://statesnapshots.s-3.com/snaps07/index.jsp.

http://www.ahrq.gov