State snapshots highlights gains and lags in health care quality

AHRQ's State Snapshots Web tool was launched in 2005. It is an application that helps state health leaders, researchers, consumers, and others understand the status of health care quality in individual states, including each state's strengths and weaknesses.

The 51 State Snapshots – every state plus Washington, D.C. – are based on 129 quality measures, each of which evaluates a different segment of health care performance. While the measures are the products of complex statistical formulas, they are expressed on the Web site as simple, five-color “performance meter” illustrations.

For a subset of 15 “State Rankings for Selected Measures,” chosen to represent a broad range of common diseases, the State Snapshots highlight specific state strengths. New York, for example, ranks best for its low suicide rate. Montana ranks first for pneumonia vaccinations for seniors. Utah ranks first for its low colorectal cancer death rate. No state is good at everything, however, and the State Snapshots point out areas in which states need improvement.

“It is clear that the nation must continue pursuing important opportunities to improve the quality of health care,” said AHRQ Director Carolyn M. Clancy, MD. “The State Snapshots help policymakers understand the breadth of those problems and how their states compare with others. With that knowledge, they are better equipped to take vital steps that will improve the health of people in their states.”

The data, drawn from AHRQ's 2006 National Healthcare Quality Report, come from various data sources that cover multiple years. The statistics provide state-specific information but also underscore the reality that some shortcomings in health care quality are widespread. On average, for example, states reported that only about 59 percent of adult surgery patients insured by Medicare receive appropriate timing of antibiotics. Only about 54 percent of men over 50 reported they ever had a flexible sigmoidoscopy or colonoscopy, according to the all-state average. Only about 54 percent of Medicare managed care patients said their health providers always listened carefully, explained things clearly, showed respect for what they had to say, and spent enough time with them.

The State Snapshots provide summaries that measure health care quality in three different contexts: by types of care (such as preventive, acute, or chronic care), by settings of care (such as nursing homes or hospitals), and care by clinical area (such as care for patients with cancer or respiratory diseases). After selecting a state on a national map, users may view whether that state has improved or worsened compared to other states in a particular area of health care delivery. The 129 measures range from preventing bed sores to screening for diabetes-related foot problems to providing antibiotics quickly to hospitalized pneumonia patients. The State Snapshots also allow users to compare a state's performance against other states in the same region, plus how a state compares against “best performing states.”

The State Snapshots Web site also offers these options for data searches:

• Strongest and Weakest Measures: This section summarizes areas in which a state has performed well compared to other states, plus areas in which a state's scores are comparatively low.
• Focus on Diabetes: Underscoring the need to confront a disease now afflicting more than 18 million Americans, this section illustrates how states compare in quality of care, treatment variations, and health care spending for diabetes.
• All-State Data Table for All Measures: With more than 5,000 entries, this downloadable spreadsheet includes all 129 individual performance measures for each state.

AHRQ's annual State Snapshots is based on data drawn from more than 30 sources, including government surveys, health care facilities and health care organizations. To access this year's State Snapshots tool, go to http://statesnapshots.ahrq.gov/.

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