Quality of health care varies widely in the region, report says

Many patients in the Puget Sound region are not getting the health care recommended by national guidelines, according to a new study.

The study also found that quality of care in the region varies widely from hospital to hospital, from clinic to clinic, and even from provider to provider within same medical group or institution.

The report, “Community Checkup”, was compiled by the Puget Sound Health Alliance, a voluntary collaboration of regional health providers, insurers, government agencies, employers, unions and other groups to improve health-care quality.

Thirty hospitals, 170 clinics and 46 medical groups participated in preparing the report, which organizers call “the most comprehensive report on health care performance ever produced” for the Puget Sound region.

The report is available online, and it is possible to search report’s findings to see how well different hospitals, medical groups and clinics did on a variety of quality measures.

An training video on the website can help you get started.

The goal of the report is to serve as a baseline to guide efforts to improve the quality of health care in the region, said Mary McWilliams, executive director of the Alliance, at a conference announcing the study’s findings today.

The study found that on many measures local health-care providers on average matched or bested the top 10% performers nationwide.

But on other measures local health-care providers did less well.

For example, because colds are caused by a virus, antibiotics, which have no effect on viruses, are not recommended,

The Alliance study found that local health-care providers on average did very well adhering to these recommendations, scoring in the top 10% nationally.

Even the lowest scoring clinics in the region did a good job, treating about 85% of patients according to the guidelines.

But when it came to screening women for chlamydia, a common and easily treated sexually transmitted disease that can render a woman infertile, local health-care providers did less well, with, on average, only 40% of women being screened according to guidelines.

Worse, the lowest scoring clinics were screening only 10% of their patients appropriately.

And while the region’s top-performing clinics bested the national top performers, they still screened only about 65% of women appropriately.

The Alliance study also found that some chronic disease care was uneven.

For example, on average, nearly 90% of patients with diabetes were having their blood sugars tested according to national guidelines, very near the national top 10% performance level.

But with eye exams it was a different story: just over 60% of diabetic patients were receiving the recommended exams.

Although this average puts the region’s performance in the top 10% nationally, 60% is still low given that these exams can help delay or prevent blindness, a common, serious complication of diabetes.

Organizers of the study pointed out that the fault does not all lie with the physicians. For example, while doctors may fail to provide recommended care in some cases, in other cases the care may not be covered by the patient’s health insurance or the copayment for the care may be prohibitively expensive, and in other cases a patient may not follow up on the doctor’s recommendation.

Lack of access to some services, particularly among minorities, is often an obstacle, said Vazaskia Caldwall, manager of Washington State’s Patient Navigator Program, which helps patients in under-served communities find their way through the health-care system.

One of the goals of the Community Checkup project is to identify obstacles that are keeping patients from receiving recommended care so steps can be taken to improve services and outcomes, the organizers said.

What the report shows is that “everyone, everyone has an opportunity to improve,” said Dr. David Flemming, Alliance board chair and director of Public Health – Seattle & King County.

The report is available online and visitors can see how well individual clinics and hospitals did on a number of quality measures.

The Report’s Key Findings:

• Regional results indicate that large numbers of patients in this region do not receive care recommended by national medical guidelines
   
• Compared to national results, we are doing well in care for diabetes, heart disease, low back pain, and avoiding the use of antibiotics for the common cold
   
• Compared to national results, we have opportunities for improvement in preventative care and avoiding the use of antibiotics for sore throat
   
• In this region, there is substantial variability in performance across clinics in many measures, indicating numerous opportunities for improvement particularly for filling prescriptionss using generic medications.

To learn more:

• Visit the Community Checkup website.
• Visit the Puget Sound Health Alliance’s website.
• Read the 174-page report which is available on the Alliance’s website.

Tags: Puget Sound Health Care Alliance, Quality Improvement, Quality of Care

Category: Health-care Policy, Hospital News