Healthcare access, quality and costs vary widely from one community to another, according to a report from the Commonwealth Fund
Using 43 metrics, including percentage of insured adults and 30-day mortality rates for heart attack, Commonwealth Fund researchers assessed health system performance in 306 hospital referral regions across the country. St. Paul, Minn., Dubuque, Iowa, and Appleton, Wis., were among the top communities overall, while Shreveport, La., and Jackson, Miss, were ranked among the bottom 10.
It's the first report from the New York-based not-for-profit to look specifically at local health systems. The Commonwealth Fund released national scorecard reports in 2006, 2008 and 2011, as well as state-by-state health system reports in 2007 and 2009.
“This first local scorecard provides a baseline for how healthcare systems are performing at the local level when it comes to the most essential functions, including whether people can get the healthcare they need, whether they receive timely preventive care and treatment, how healthy they are, and how affordable healthcare is,” Cathy Schoen, the Commonwealth Fund's senior vice president for policy, research and evaluation, and one of the co-authors of the report, said in a release.
While there were geographic patterns of performance, with communities in the South tending to perform worse on many of the 43 indicators, there were also significant gaps within states, the organization said in a news release. For instance, there was a difference of 27 percentage points between two Kentucky communities' performance on a measure of diabetes management.
If all 306 communities performed as well those at the top, “Medicare would save billions of dollars on preventable hospitalizations and readmissions,” the authors said in the release.