Seattle Best for Health Care?

[Guest guest]

This was in this morning's paper.

We ranked BEST with " Patients in Seattle received, on average, only

about 60 percent of recommended care for their ailments... " Scary,

very scary.

Thursday, May 6, 2004

Seattle health care ranks best of a rather poor lot

Service falls short in 12 cities, study shows

By JULIE DAVIDOW

SEATTLE POST-INTELLIGENCER REPORTER

Seattle scored the best among 12 metropolitan areas across the

country in a new study of health care quality -- but not by much.

Patients in Seattle received, on average, only about 60 percent of

recommended care for their ailments, compared with a low of 51

percent in Little Rock, Ark.

" That was certainly the best in the country, but I think most

readers would agree they would not be satisfied with a 59 percent on

their spelling test, " said Dr. Asch, a Los Angeles-area

physician and one of the study's authors.

The RAND Corp. study, published in the May issue of the journal

Health Affairs, provides the first comprehensive comparison of

health care between cities, the authors said.

The universally poor performance points to structural flaws in the

American health care system, rather than indicting individual

doctors or hospitals, according to the study's authors.

" Failing to (deliver) the care people need means we have thousands

of needless deaths each year, " said McGlynn, the study's

lead author.

The quality gap existed in cities with disparate median incomes,

numbers of uninsured residents and medical facilities.

" No matter where you live, you are at risk for poor care even if you

live in a community with some of the best teaching hospitals in the

country, " said Dr. Eve Kerr, one of the authors of the study, which

was funded by the Wood Foundation.

About 7,000 patients in 12 randomly selected metropolitan areas with

more than 200,000 people, including Miami, Greenville, S.C., and

Orange County, Calif., agreed to allow researchers access to two

years of their medical records. Participants included the uninsured

as well as those with private or public insurance.

From the records, researchers collected treatment information for 30

common acute and chronic conditions, including asthma, diabetes,

high blood pressure, heart failure, depression and breast cancer.

Patient care was then measured against standards gleaned from a

review of national guidelines and medical literature.

A panel of experts also reviewed the study's standards for each

medical condition.

The quality of care varied across conditions, with treatment for

cataracts and hypertension among the best and alcoholism and ulcers

receiving some of the lowest scores.

Diabetics, for example, received appropriate care only 45 percent of

the time. Less than one-quarter had their blood sugar levels

measured regularly.

Unstable blood sugar can cause kidney problems and blindness in

diabetic patients.

Seattle topped other cities in care for depression, but lagged

behind in cardiac care and immunizations.

Americans tend to believe the main problems with health care are

cost and lack of access, rather than quality, said Greg Vigdor,

president of the Washington Health Foundation.

They also believe their own doctors and communities provide high-

quality care.

But " everybody that knows the system knows there are gaps, " Vigdor

said.

Poor quality across cities is not surprising and reflects " the

disorganized nature of the health care system, or non-system

really, " said Dr. Sugarman, president and chief executive

officer of Qualis Health, a Seattle-based health care quality-

improvement organization.

Recent efforts to improve diabetes care across the state might have

contributed to Seattle's higher overall score, Sugarman said.

In addition, U.S. News & World Report recently named the University

of Washington the top medical school for primary care in the country.

Still, the average 15-minute appointment with a doctor doesn't arm

patients with everything they need to manage a chronic condition

such as diabetes, Sugarman said.

For patients with multiple health problems, care is often juggled

among specialists, hospitals and general practitioners, leaving gaps

in which basic treatments such as flu shots, blood-pressure

medications or aspirin after a heart attack could be overlooked,

Ashe said.

Electronic medical records, the study's authors suggested, could

improve health care quality by helping doctors keep track of tests

and medications and creating a more unified system.