Monday, November 15, 2010

Some grades are in

In a comment below, Jim Conway offers some data from the Commonwealth Fund that sheds light on the question posed. I have copied the summary above.

Recall that the proposition was: "There is lots of evidence that Massachusetts health care is the best in the country." We get excellent grades for access and equity. This is not surprising given the state's universal insurance coverage law.

We do well on "healthy lives," too, but I do not know how much of that derives from the health care system as opposed to relative lifestyle (smoking, obesity, and the like) in the Bay State.

But we clearly have a problem when it comes to overuse of the hospital system. Also, the performance with regard to standard indicators of care is not exemplary.


Anonymous said...

I applaud the effort to find data to support or refute a blanket statement. Clearly your state does reasonably well. But, as for "avoidable hospital use", one must remember that any hospital use entails risks, and therefore overuse will act to pull down the overall quality of outcomes. More care is definitely not equivalent to better care - and Boston is certainly at high risk for the former.

nonlocal MD

Anonymous said...

It is really difficult to remove the fact that Massachusetts is one of the highest income, highest educated and lowest obesity states in the country. Add in our low level of violent deaths like homicide and you are naturally going to have better health outcomes and longer life span. I think these socio-economic factors have much more to do with our outcomes than the overuse of medical services that exists here. They say the most expensive thing in healthcare is a physician's pen... bottom line is that we have more physicians than anyone else, more high cost academic medical centers than anyone else and that is going to result in much higher costs as all of these physicians do work, perform procedures and order tests. I think much of this work performed does little or nothing to our overall length of life, although there may be an improvement in quality of life due to all of this extra work (a sore hip in an elderly patient in England is probably a hip replacement patient here in the U.S.).

Anonymous said...

Paul, thank you for asking for data! It is stunning how much anecdote passes for evidence in even the most highly educated populations. Physicians, managers, staff, board - all are guilty. Instead of nodding ceremoniously across meeting tables, we should be asking: what data do we have appropriate for each level of variation in question? It is the responsibility of all leaders at every level to push hard on this.

76 Degrees in San Diego said...

Actionable data usually comes in smaller aliquots. "All politics is(sic) local." "Drill, baby, drill!".....down.