There is wide variation in access to care between different U.S. regions, according to a study in the New England Journal of Medicine.
The Commonwealth Fund evaluated the geographic variation in access to care and the implications for quality. The researchers used data from a previous Commonwealth Fund report, "Rising to the Challenge: Results from a Scorecard on Local Health System Performance" to assess this variation. The scorecard includes results for all 306 hospital referral regions, which are regional healthcare markets.
The data show that in 2009 and 2010, the proportion of adults aged 18 to 64 without health insurance in the three HRRs in Massachusetts — where a mandate requires health coverage for residents — was 5 percent, whereas the percentage was more than 50 percent in two areas of Texas.
There was also geographic variation in the following areas:
• The proportion of adults who went without care because of cost — 5 percent to 33 percent.
• The proportion of adults who report having a regular doctor — 59 percent to 93 percent.
• The proportion of adults aged 50 or older with a diagnosed chronic disease who visited a doctor in the past two years — 67 percent to 95 percent.
These differences translated to differences in outcomes. Regions that scored in the bottom decile on measures of access and affordability had 32 percent of Medicare beneficiaries receive prescriptions for unsafe medicines. In contrast, areas with strong access had only 18 percent for this measure. In addition, 34 percent of Medicare beneficiaries in regions in the bottom decile reported having poor health-related quality of life, compared with only 24 percent in the high-access areas.
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The Commonwealth Fund evaluated the geographic variation in access to care and the implications for quality. The researchers used data from a previous Commonwealth Fund report, "Rising to the Challenge: Results from a Scorecard on Local Health System Performance" to assess this variation. The scorecard includes results for all 306 hospital referral regions, which are regional healthcare markets.
The data show that in 2009 and 2010, the proportion of adults aged 18 to 64 without health insurance in the three HRRs in Massachusetts — where a mandate requires health coverage for residents — was 5 percent, whereas the percentage was more than 50 percent in two areas of Texas.
There was also geographic variation in the following areas:
• The proportion of adults who went without care because of cost — 5 percent to 33 percent.
• The proportion of adults who report having a regular doctor — 59 percent to 93 percent.
• The proportion of adults aged 50 or older with a diagnosed chronic disease who visited a doctor in the past two years — 67 percent to 95 percent.
These differences translated to differences in outcomes. Regions that scored in the bottom decile on measures of access and affordability had 32 percent of Medicare beneficiaries receive prescriptions for unsafe medicines. In contrast, areas with strong access had only 18 percent for this measure. In addition, 34 percent of Medicare beneficiaries in regions in the bottom decile reported having poor health-related quality of life, compared with only 24 percent in the high-access areas.
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Study Shows Significant Variation in Costs, Quality and Access Across CommunitiesStudy: Massachusetts Health Reform Increased Inpatient Service Utilization
GAO Reports Increased Admissions for Ortho Implantable Medical Devices 2003-2009