A Commonwealth Fund analysis of more than 40 measures of healthcare access, quality and cost found major differences across 306 U.S. communities. The analysis, which looked at avoidable hospital visits, infant mortality, routine checkups and more than three dozen other measures, also found an association between greater access and better quality and outcomes, according to a newly released report by the health policy not-for-profit.
Access, costs, quality vary widely by area, analysis finds
Regions of the Upper Midwest and Northeast ranked higher than communities in the Gulf Coast and South Central states, the report said.
Among the findings: 93% of adults reported a usual source of care in the highest-ranked community, compared with about 59% of those in the lowest-ranked spot. Buffalo and Rochester in New York and Johnstown and Lancaster, Pa., were listed as the top local areas. The report did not identify the lowest-ranked communities.
After adjusting for risk, 1 out of 5 patients died within 30 days of being hospitalized for a heart attack in the lowest-ranked community compared with 12% of those in the top-ranked location. The report listed Elyria, Ohio, Hackensack, N.J., and Traverse City, Mich., as top-ranked locations. Imaging costs per Medicare enrollee totaled $110 in the cheapest community and $639 in the most expensive locale. Medicare imaging rates were lowest in Grand Junction, Colo., Lebanon, N.H., and Provo, Utah.
The research, which used 2008-10 data from multiple, largely public sources, found that Medicare spending often did not parallel spending among the commercially insured. The analysis also found that poverty was associated with higher rates of being uninsured and less preventive care, but some low-income communities scored highly on prevention and treatment measures.
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