NCPA - National Center for Policy Analysis


June 13, 2007

If you live in Hawaii, chances are you are better placed, health-wise, than the rest of the country, and certainly better than the residents of Mississippi and Oklahoma.  That's the determination of a new survey by the nonprofit Commonwealth Fund that ranks the health-system performance of all 50 states plus Washington, D.C. 

  • Hawaii comes out No. 1 in the rankings, while Mississippi and Oklahoma tie for last place.
  • The researchers conclude that if all the states could reach the low levels of mortality achieved by Hawaii, some 90,000 fewer deaths before the age of 75 would occur annually.

One stark finding: Even in the best states, performance fell far short of optimal standards. For example:

  • The percentage of adults age 50 or older receiving all recommended preventive care ranged from a high of 50 percent in Minnesota to a low of 33 percent in Idaho.
  • Meanwhile, the percentage of diabetics receiving proper care ranged from 65 percent in Hawaii to 29 percent in Mississippi.

The study highlights some of the reasons behind the high cost of health care in the United States by measuring avoidable uses of hospitals and medical care:

  • Rates of potentially preventable hospital admissions ranged from more than 10 percent of Medicare enrollees in the worst performing states to 5 percent of enrollees in the five best.
  • There was also a twofold variation in rates of readmission within 30 days of leaving the hospital (from 24 percent in Louisiana and Nevada to 13 percent in Vermont and Wyoming); such rapid readmissions to hospitals is often a sign that care was not delivered optimally the first time.
  • If all states could reach low levels of preventable hospital admissions and readmissions for Medicare recipients, hospitalization rates for senior citizens alone could be reduced by 30 percent to 47 percent and save Medicare $2 to $5 billion a year.

Source: Catherine Arnst, "The Sorry States of Health Care: A state-by-state study shows who has the best and worst grades on 32 health indicators, and even the best are none too good," BusinessWeek, June 13, 2007; based upon: Joel C. Cantor et al., "Aiming Higher: Results from a State Scorecard on Health System Performance," Commonwealth Fund, June 13, 2007.


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