With disappointment, and continuing determination to help Floridians gain access to quality Health Care, I share the following findings of the Commonwealth Fund. The entire state-by-state rankings can be found at http://www.commonwealthfund.org/statescorecard.

Sincerely,

Dr. Marion D. Thorpe, Jr.

Florida Health Care ranks low

The high number of uninsured residents has been leading to poor-quality health care in Florida, a study reports.

Miami Herald, Herald.com
Posted on Wednesday, June, 13, 2007
BY JOHN DORSCHNER
jdorschner@MiamiHerald.com

State rankings

Here's how the states ranked in a major study of healthcare access, cost, quality and efficiency.

1.Hawaii

2.Iowa

3.(tie) New Hampshire

3.(tie) Vermont

5.Maine

6.Rhode Island

7.Connecticut

8.Massachusetts

9.Wisconsin

10.South Dakota

43.Florida

SOURCE: Commonwealth Fund State Scorecard on Health System Performance, 2007

With many people lacking access to care and others facing an abysmally low-quality system, Florida ranks No. 43 in the nation in the first state-by-state scorecard of healthcare-system performance.

The survey, being officially released today by the Washington-based Commonwealth Fund, shows that Florida ranks 40th in access to care, 45th in quality and 39th in equity of care. The state does much better in ''avoidable hospital use and costs,'' ranking 26th.

Hawaii ranked first overall, followed by Iowa and New Hampshire. Tied for last were Oklahoma and Mississippi.

''Access is highly correlated with quality,'' said Commonwealth President Karen Davis in a conference call with reporters on Tuesday. Her nonprofit organization specializes in health and social policy issues.

Access generally starts with insurance, which in turn leads to having a regular doctor who can do annual checkups and regular preventive care, stopping problems before they lead to expensive trips to the emergency room.

''Four of the five leading states in the access dimension -- Massachusetts, Iowa, Rhode Island and Maine -- also rank among the top five states in terms of quality,'' the 74-page report stated.

Among the 50 states and the District of Columbia, Florida ranks 50th in coverage, with 26.9 percent of adults under 65 uninsured. Only Texas does worse in the percent of uninsured, and it ranks 46th in quality, a measure that includes such criteria as giving hospitalized patients the necessary treatments and antibiotics.

Joel C. Cantor, a Rutgers University researcher who conducted the survey, said he thought the link between insurance and quality was that insurance brought money into the healthcare system, whereas ``a lack of coverage and high number of uninsured leads to financial distress, less money for information technology as one example.''

INEQUALITIES

Lack of coverage also can lead to inequities, measuring how the poor and minorities do in getting needed care. Florida ranked in the lower half in terms of racial/ethnic equity, according to the study, and in the lower quarter in terms of income equity.

The state did considerably better in avoidable hospital use and costs, which measures such things as Medicare patients being readmitted within 30 days of being discharged and children who had to be admitted because of asthma problems.

The Commonwealth study did not break down areas within states. Separate studies by Dartmouth researchers have found that South Florida hospital costs for Medicare patients are among the very highest in the nation.

Florida also did well in another Commonwealth measure, called Healthy Lives, in which it ranked 25th.

That measure includes infant mortality, percentages of adults who have to limit activities, and deaths from breast cancer and colorectal cancer -- diseases generally considered to be treatable if detected early.

Another state-by-state survey, released by a federal agency on Monday, confirmed the Commonwealth data.

OTHER DATA

The State Snapshots, produced by the Agency for Healthcare Research and Quality, showed that in 129 quality measures, Florida ranked in the lower 25 percent of states.

Confirming the Commonwealth data, the agency said Florida did well by having low rates of death by colorectal and breast cancers. But it ranked 49th in patient satisfaction with Medicare, 48th in diabetic adults given flu shots and 46th in percentage of patients saying they can always get an appointment for care.

The Commonwealth researchers noted there was much room for improvement.

''If all states could approach the low levels of mortality from conditions amenable to care achieved by the top state, nearly 90,000 fewer deaths before the age of 75 would occur annually,'' the report said.

While some political observers believe healthcare reform may be tackled first by some states, Commonwealth President Davis said, ''federal action is essential,'' because lower-income states, particularly in the South, don't have the funds to help the uninsured.

''Moving to extend affordable health insurance to all is critical,'' Davis said.