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

But some states have declined to participate in some categories, he adds. "They just never thought about doing it, or they're too small, or they have other bizarre kinds of restrictions. A couple of states have rules that prohibit collecting such information or if it does collect it, prohibits the state from sending it to us." In the case of one state, a movement is afoot in the state Legislature to change that rule.

Such ranking tools will doubtless become more important as the federal government looks more seriously at finding ways to measure care with an emphasis on comparative effectiveness as a way of determine best outcomes and quality.

Each measure was rated on a bell curve, so that some states did well while others did poorly. Massachusetts, Moy says, is in the top 10 for more than half the quality measures that were tracked, but did not do well in home health or nursing home measures.

"On the flip side, we highlight Nevada, which is at the bottom 10 for a big chunk of the quality measures, but does fairly well in home health care," Moy says. "New England states tend to do well, but southwest and south central states tend to be the worst."

This is the first year AHRQ has published information on rates of sepsis among patients admitted to hospitals for elective surgery. Moy says some hospitals and states may be worried about the kind of feedback they might get, and are concerned about how these rankings may reflect on the quality of care delivered in hospitals in that state.

Other measurements ranked by this Web site include the percentage of heart attack patients for whom medication was given within 30 minutes, the percentage of hospitalized patients with pneumonia who had blood cultures collected before antibiotics were administered, and the percentage of nursing home patients who spent all or most of their time in a bed or a chair.

The data also filters general information on state performance by disease category. For example, for each state, one can see rankings on cancer, diabetes, end stage renal disease, heart attack care, maternal and child health, mental health, respiratory diseases, HIV and AIDS, surgical care, nursing home care, patients' ability to get timely appointments, and patient experience of care.

The expansive data file is available in Excel under the heading "All state data tables for all measures."