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US states get healthcare ratings

BMJ 2005; 330 doi: (Published 14 April 2005) Cite this as: BMJ 2005;330:866
  1. Janice Hopkins Tanne
  1. New York

    Americans can now get information about how well their state is providing vaccinations, prenatal care, pneumococcal vaccine for elderly people—and many more details.

    The quality of health care that Americans get varies widely from state to state, according to statistics from the second annual report comparing the 50 states and the District of Columbia. The report, from the Agency for Health Care Research and Quality, looks at 14 categories of healthcare quality. These include various measures such as who gets flu vaccines, the percentage of Medicare patients hospitalised with pneumonia who got antibiotic treatment, how many children were vaccinated, how good is prenatal care, and rates of suicide.

    The report, which was mandated by Congress, examined data for 2003 from hospitals, health plans, nursing homes, and other sources. About 100 measures of medical quality were reported.

    The agency did not release a ranking of the states but instead listed individual results for the 50 states and the District of Columbia to show how each state compared with a national average. Carolyn Clancy, head of the agency, said that there was no best or worst state but that improvement was needed in every state.

    Some states performed well in one area but not in others. Idaho, for example, had a low prevalence of colorectal cancer. However, it also, coincidentally, had a high proportion of people who had not had their blood cholesterol concentration checked.

    Donald Berwick, president and chief executive officer of the Institute for Healthcare Improvement, welcomed the report but said the United States still had an “embarrassing gap” in the quality of care when compared with other western democracies.

    “It is a politically correct mantra to claim that the US has the best healthcare system in the world. It does not,” he said.

    Americans can also get reports about how well their hospitals complied with quality measures relating to treatment of heart attacks, heart failure, and pneumonia.

    The report of the state by state results are at and the reports on hospitals are at

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