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Who's the Best? Web site Ranks Most States in Quality Measures

Cheryl Clark, for HealthLeaders Media, June 30, 2009

The Agency for Health Research and Quality recently expanded its "State Snapshots" to illustrate with colorful graphics the wide variation in care provided from state to state across the country.

"Every state has areas where it does well, as well as opportunities for improvement. We generally think this is a good 'get people going' kind of tool," says Ernest Moy, MD, medical officer for the Agency for Health Research and Quality, which produced the Web-based application.

Hospitals, state health officials and other providers can now see both how their states are performing relative to data collected in previous years as well as how they compare with other states. "From our perspective, comparison with other states has the greatest potential for the use of this data," Moy said.

Here are a handful of the findings:

  • Maryland had the worst hospital post surgical sepsis infection rate of any other state, but Oregon had the best.
  • Texas and California had the worst track records in giving surgical patients antibiotics at appropriate times, while South Dakota and Maine had the best performance rates in this category.
  • Utah had among the lowest rates of death per 1,000 adults admitted with conditions or diseases associated with low-mortality, but Iowa had among the highest.
  • Minnesota had the lowest rates of "iatrogenic pneumothorax," or incidents in which hospital procedures provoked air accumulation in the pleura of the lung, but Vermont had the highest.

The agency does not speculate on why such great variations in quality measures vary so much.

The state snapshots Web site shows data that ranks each participating state in more than 100 quality measures based on the place of care (preventive, acute, or chronic care) setting, such as a hospital, ambulatory, nursing home, or home health care setting, and by type of condition, such as cancer, diabetes, heart disease, maternal and child health, and respiratory disease.

Included are several new scoring areas, such as the prevalence in each state of adult asthma rates and the numbers of potentially preventable hospitalizations for children, adults, and the elderly.

Each participating state's performance is marked with a pink, yellow, and green performance meter, which illustrates state scoring with two needles, one that shows how the state is doing compared to a prior year, and the other shows how it compares with other states.

AHRQ collects but does not publish data from about eight states–depending on the category–because it's not statistically significant or because of concerns that small numbers may identify a patient or provider, Moy says.

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