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Healthcare Quality Varies by Community: Where Yours Ranks


How does the quality of healthcare available in the community where you practice match up to other communities?

How does the quality of healthcare available in the community where you practice match up to other communities? 

A recently released report, the Scorecard on Local Health Systems Performance, provides some clarity.

It is the first report ever to use comparative data to assess the performance of 306 local healthcare regions across the country, according to healthcare research and innovation foundation The Commonwealth Fund. These regions are also known as hospital referral regions (HRRs).

The report ranks each HRR in four categories: access to healthcare, prevention and treatment, costs and rates of potentially avoidable hospital use, and health outcomes. It also provides an “overall health system performance” category, which is a combination of all four rankings.

To measure performance in each of the four categories, the report used various sources, including the latest government surveys, registries, publicly reported quality indicators, vital statistics, mortality data, and administrative databases.

Here are some of the report’s key findings:

Local area communities in the Northeast and Upper Midwest tend to rank higher for “overall health system performance,” meaning they perform better for quality, access, costs, and outcomes, than most HRRs in the South.

In fact, all 10 of the communities with the lowest rankings for overall health system performance are located in southern states. They are:

1. Meridian, Miss.
2. Oklahoma City, Okla.
3. Shreveport, La.
4. Jackson, Miss.
5. Alexandria, La.
6. Texarkana, Ark.
7. Beaumont, Texas
8. Hattiesburg, Miss.
9. Oxford, Miss.
10. Monroe, La.

The report found that the HRRs with the highest overall rankings are usually located in states where efforts to expand health insurance coverage are underway, where there is strong state and community leadership, and where there is a culture of collaboration and improvement.

The top10 communities with the highest overall performance are:

1. St. Paul, Minn.
2. Dubuque, Iowa
3. Rochester, Minn.
4. Minneapolis, Minn.
5. Appleton, Wis.
6. Santa Rosa, Calif.
7. La Crosse, Wis.
8. St. Cloud, Minn.
9. Manchester, N.H.
10. San Mateo County, Calif.

About 40 percent of the country resides in HRRs located in large cities, according to the report.
Of these HRRs, Boston, Minneapolis and St. Paul, Minn., the San Francisco Bay area, Seattle, and Arlington, Va., are some of the strongest overall performers for health quality.

Though the report did not include state-based performance rankings, a previous report, the 2009 edition of The Commonwealth Fund's State Scorecard on Health System Performance, did.

According to that report, the 10 states with the highest overall performance based on access, quality, costs, and health outcomes are:

1. Vermont
2. Hawaii
3. Iowa
4. Minnesota
5. Maine
6. New Hampshire
7. Massachusetts
8. Connecticut
9. North Dakota
10. Wisconsin

The 10 states with the lowest overall performance based on access, quality, costs, and health outcomes are:

1. Illinois
2. New Mexico
3. Florida
4. Kentucky
5. Texas
6. Nevada
7. Arkansas
8. Louisiana
9. Oklahoma
10. Mississippi

For more state-specific data, including physician density statistics, malpractice climate numbers, and cost of living rates, view our 2011 Best States to Practice report.

What do you think of the study findings? Do you practice in one of the communities that performs highest for overall healthcare? Do you practice in one of the worst?


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