Agency for Healthcare Research and Quality (AHRQ): AHRQ’s State-by-State Health Care Performance
To assist health leaders an annual annual analysis has been developed to identify areas of health care delivery that need quality improvement. It now includes important information such as each State’s rate of obesity, health insurance coverage, mental illness and the number of specialist doctors.
Those along with other measures are part of the 2007 State Snapshots released by the federal Agency for Healthcare Research and Quality (AHRQ). The updated State Snapshots Web tool also tracks States’ progress toward reaching government-set health goals for 2010.
Prior to the release of state snapshots the health care quality site summarized 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 a simple, five-color illustration, which rates performance from very weak to very strong. There are several areas of health care delivery where consumers can explore if a State has improved or worsened compared to other states.
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 measures that are selected. The rankings display how well or poorly a state is performing in all areas. For example, Texas is 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 is collected from the 2007 National Healthcare Quality Report. That report, released March 3 and is available at www.ahrq.gov/qual/qrdr07.htm, provides a national portrait of health care quality. It illustrates the quality of health care improved by an average of 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.
The 2007 State Snapshots 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.ahrq.gov/snaps07/index.jsp.