AHRQ: State gains in health care quality seen

States have made promising gains in health care quality, although more remains to be done in areas ranging from cancer screening to treatments of heart attack patients, according to new state snapshots released by the federal Agency for Healthcare Research and Quality (AHRQ). The Internet-based state snapshots tool was launched in 2005 as a way to help state health leaders, researchers, consumers, and others understand the status of health care quality in individual states, including each state's strengths and weaknesses.

The snapshots cover each of the 50 states plus the District of Columbia and are based on 129 quality measures that each evaluate a different segment of health care performance. AHRQ says the measures are products of complex statistical formulas, but are shown on the web site as simple five-color "performance meter" illustrations.

For a subset of 15 "State Rankings for Selected Measures," chosen to represent a broad range of common diseases, the State Snapshots highlight specific state strengths. Thus, New York ranks best for its low suicide rate, while Montana ranks first for pneumonia vaccinations for seniors, and Utah is first for its low colorectal cancer death rate. No state is good at everything and the State Snapshots point out areas where states need improvement, officials said.

The data in the snapshots are drawn from AHRQ's 2006 National Healthcare Quality Report. They come from various data sources covering multiple years. AHRQ officials said the statistics provide state-specific information but also underscore the reality that some health care shortcomings are widespread. On average, for example, states reported that only 59% of adult surgery patients covered by Medicare receive appropriate timing of antibiotics. And only 54% of men older than age 50 reported they ever had a flexible sigmoidoscopy or colonoscopy, according to the all-state average. Only about 54% of Medicare managed care patients said their health care providers always listened carefully, explained things clearly, showed respect for what they had to say, and spent enough time with them.

The State Snapshots provide summaries that measure health care quality in three different contexts—type of care such as preventive, acute, or chronic care; care settings such as nursing homes or hospitals; and care by clinical area such as care for patients with cancer or respiratory diseases. The 129 quality measures range from preventing bedsores to screening for diabetes-related foot problems to providing antibiotics quickly to hospitalized pneumonia patients. The snapshots allow users to compare a state's performance against other states in the same region and against "best-performing states."

"It is clear that the nation must continue pursuing important opportunities to improve the quality of health care," said AHRQ director Carolyn Clancy, MD. "The State Snapshots help policy-makers understand the breadth of those problems and how their states compare with others. With that knowledge, they are better equipped to take vital steps that will improve the health of people in their states."

The State Snapshots are available online at http://statesnapshots.ahrq.gov.