Improvements in some measures of nursing home and hospital quality were among the few bright spots in a new state-by-state analysis from the Commonwealth Fund that shows healthcare systems nationwide are under a great deal of stress.
Nursing homes overall showed a marked improvement in a number of quality of care areas, including fewer instances of pressure ulcers, less use of physical restraints and reduced reports of pain, according to the 2009 State Scorecard on Health System Performance, which was released Wednesday. Every state in the union saw at least a 5% performance improvement when it came to both pain management and use of restraints. It wasn’t all good news for nursing homes, however: The majority of states saw hospital and nursing home readmissions increase over the results from the 2007 Scorecard, indicating “poor care coordination and continued inefficiency in the use of resources,” according to report authors.
Other results in different areas were spotty. Costs, quality and access to care varied wildly state-to-state and measure-to-measure, the report says. Healthcare coverage for adults is deteriorating in many states, and even the best-performing states experience “persistent gaps” when it comes to quality, access and affordability. Vermont, Hawaii and Iowa occupy the top three spots on the Scorecard, while Oklahoma and Mississippi bring up the rear, echoing their 2007 results. More information is available at www.commonwealthfund.org.
