State has top medical care

Ran on Tuesday, June 12, 2007

State has top medical care

By Journal Sentinel and Leader-Telegram staff

Led by the performance of its hospitals, Wisconsin was ranked first in the nation in health care quality based on information compiled by the federal Agency for Healthcare Research and Quality.
The ranking - based on 129 quality measures in four different care settings - gave Wisconsin the highest overall score among 50 states and the District of Columbia.
The state’s hospitals also were given the highest score in the country.
The information released Monday marked the first year that the agency compiled and released an overall score for each state. The agency has been releasing state information on health care quality for four years.
Wisconsin historically has ranked high in surveys on health care quality.
“We’re pretty fortunate in the Eau Claire area to have the quality of health care we have,” said Bob McCoy, president of the Chamber of Commerce.
Dr. Terrance Borman, medical director of Luther Midelfort, said the hospital has been using comparative numbers similar to the ones released for years.
“It speaks well for the effort in Wisconsin,” Borman said. “It’s been very progressive about moving quality care upwards.”
Vic Galfano, an assistant administrator at Sacred Heart Hospital, said he wasn’t surprised by the numbers.
“Wisconsin has had a long-standing high ranking,” he said.
Sacred Heart had a board monitor the quality of care before it became mandatory, Galfano said. The hospital also is listed on the voluntary Web site www.wicheckpoint.org, which delivers consumer-focused initiatives providing quality health care measures.
Galfano said Sacred Heart has conducted its own quality research for many years.
Wisconsin also was among the five best-performing states in ambulatory care and ranked in the top 25 percent for nursing home care.
Home health care was the anomaly: The state’s overall score was 25, far below the scores of 95 for the top performing states, Michigan and Pennsylvania.
Richard Thoune, director of the Eau Claire City-County Health Department, said the home health care agency can examine the numbers and make adjustments.
“There’s plenty of room for improvement in home health care,” Thoune said.
The public now has access to information that less than a decade ago didn’t exist or typically was confidential.
Now, information on how specific hospitals, nursing homes and home health care agencies perform on certain measures is available through Medicare’s Web site.
The effort to develop accepted quality measures, though, still remains in its early stages.
“We’ve made incredible strides over the past five years in terms of the specificity of the measures,” said Ed Kelley, director of national health care reports for the Agency for Healthcare Research and Quality. But he added, “There’s still a long way to go.”
The scores compiled by the agency are based on an array of performance measures.
Some examples are foot exams for people with diabetes, ease of appointments for people in the Medicare program, low-birth weight babies, recommended care for heart attack patients and avoidable hospitalizations for pediatric asthma patients.
Wisconsin ranked better than average in those areas and others. No state, however, did well in all areas. The state ranked “worse than average,” for example, in suicide deaths and avoidable hospitalizations for influenza.
Noting areas where the health care system falls short is one of the goals in compiling the information.
Nationally, only about 59 percent of adult surgery patients insured by Medicare, for instance, receive antibiotics at the appropriate time. In Wisconsin, the figure was 66.1 percent - better than the national average but below a respectable score.
Developing good measures of health care quality also is just the first step.
Thoune said the high cost of health care in the area is worth the extra money.
“It may cost more, but you’re getting what you pay for,” he said.
“We also have to think about how we are going to use this data,” Kelley said.
Nationally, hospitals have shown significant improvement in some quality measures. The progress in ambulatory care, in contrast, has been slower.
“That’s the next challenge,” Kelley said.
For now, Wisconsin’s hospitals and other health care providers are doing better overall than their counterparts in most states.
“We’ve made a great start,” Queram said. “And we just need to continue improving.”