Quality holds steady, but care is still inconsistent
Clinic-level data is now available for diabetes care
ST. PAUL, Minn., Nov. 15 /PRNewswire-USNewswire/ -- The overall quality of health care in Minnesota and border communities held steady in 2006 with no dramatic gains in any category monitored by MN Community Measurement, a St. Paul-based nonprofit group dedicated to improving health care quality, according to its annual ratings announced today.
"We observed modest declines in the quality of some types of care and modest increases in others. The net effect across our measures was 'status quo,'" said Jim Chase, executive director of MN Community Measurement. "This should be a wake-up call to medical providers, payers, purchasers and patients. We must all put more energy and resources into making health care better."
MN Community Measurement's performance ratings for health care delivered by 128 medical groups during 2006 -- up from 103 groups rated last year for care delivered in 2005 -- are available at www.mnhealthcare.org. Copies of the written report may be downloaded from the site beginning Monday, Dec. 3. The ratings include data from nearly all of the health systems that serve Minnesotans, as well as some medical groups in North Dakota, South Dakota and western Wisconsin.
Variation still a quality improvement challenge
Consistent with its four previous annual reports, MN Community Measurement noted wide variation in the performance of medical groups. For example:
-- The percentage of children aged 2-18 with sore throats who received a strep test and were appropriately given an antibiotic ranged from 99% at the highest-performing medical group to 26% at the lowest.
-- The percentage of women aged 16-25 who identified themselves as sexually active and received at least one screening test for the sexually-transmitted disease Chlamydia ranged from 66% to 3%.
-- Even the measure with the smallest range of variation - Optimal Diabetes Care, which focuses on tight control of blood sugar, blood pressure, cholesterol, daily aspirin use and tobacco-free status for patients with diabetes - had a 19 percentage-point spread, from 20% to 1%.
"The range between the medical groups with the highest and lowest rates on any given measure hasn't changed much in the four years we've been tracking these data," Chase said. "The low-performing medical groups need to adopt some of the systems that the high-performing groups have used to improve their care. But that will only get us so far. The top-performing medical groups may have accomplished all they can within the constraints of the current health care system. Our findings point to a need to redesign the health care system to unleash its full potential to give the best quality and value to all patients, as well as to provide more support to medical groups that aren't performing well."
The most promising initiatives to increase health care quality and value are efforts by hospitals, medical groups, health plans and purchasers to increase the involvement of patients in their care and to change payment systems to enable innovative health care delivery. MN Community Measurement is working with the Institute for Clinical Systems Improvement, the Buyers Health Care Action Group and others to provide measurements that support initiatives focused on these issues.
Several groups maintain highest rates; others show significant improvement
In other findings, MN Community Measurement observed this year that several medical groups have achieved consistently high ratings on multiple measures. Park Nicollet Health Services earned three stars for results above the medical group average on 11 of this year's 12 quality measures, while HealthPartner