Report: Health System Quality Varies Among Calif. Communities
Health care access, quality and costs vary among California communities, according to a national report by the Commonwealth Fund, the Los Angeles Times reports.
The study found that, overall, higher income areas in the U.S. were more likely to have better health system performance than lower income areas (Terhune, Los Angeles Times, 3/14).
Methodology
For the report, researchers ranked 306 hospital referral regions across the country based on 43 health-related indicators, such as 30-day heart attack mortality rates and the percentage of uninsured adults (McKinney, Modern Healthcare, 3/14).
Researchers used data mostly from 2008 to 2010 (Los Angeles Times, 3/14).
This is the first Commonwealth Fund report to focus on local health systems.
National Rankings
The highest-ranking communities in the U.S. for health system performance included:
- St. Paul, Minn.;
- Dubuque, Iowa; and
- Appleton, Wis.
Some of the lowest-ranking regions in the U.S. were Shreveport, La. and Jackson, Miss. (Modern Healthcare, 3/14).
California Rankings
Out of the 306 U.S. communities studied:
- Santa Rosa ranked 6th;
- San Mateo County ranked 9th;
- San Francisco ranked 50th;
- Ventura ranked 93rd;
- Orange County ranked 142nd;
- San Diego ranked 150th;
- Palm Springs/Rancho Mirage ranked 187th;
- San Bernardino ranked 220th;
- Los Angeles ranked 225th; and
- Bakersfield ranked 234th.
According to the Times, Los Angeles ranked lower because its rate of uninsured residents -- 31% -- is higher than average and because it has a shortage of basic preventive care services available. However, the area ranked among the highest communities in the U.S. for avoiding unnecessary emergency department visits among Medicare beneficiaries (Los Angeles Times, 3/14).
Santa Cruz County also ranked among the highest communities in the U.S. for reducing dependence on ED services among Medicare beneficiaries (Gumz, Santa Cruz Sentinel, 3/14).
In addition, Los Angeles, Orange County and Ventura had below-average costs for patients with private insurance, according to the report (Los Angeles Times, 3/14).
Implications
Karen Davis, president of the Commonwealth Fund, said, "This report shows where you live in the country largely determines, better or worse, the kind of health care you will receive."
Cathy Schoen -- coauthor of the report and a senior vice president at the Commonwealth Fund -- said, "Local communities with higher rates of poverty over 20% tend to lag behind more affluent communities, particularly for access and preventative treatments."
Davis said that she hopes legislators and health industry leaders will assess the practices of the high-ranking communities and use them to improve patient care and curb increasing health costs (Los Angeles Times, 3/14).
The authors of the report said Medicare would "save billions of dollars on preventable hospitalizations and readmissions" if all the communities that were studied performed as well as the highest ranking communities (Modern Healthcare, 3/14).
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