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CHICAGO -- Treatment of Medicare patients varies widely by state when it comes to heart failure, stroke, breast cancer and other life-threatening illnesses, according to a new federal study. Medicare patient
treatment varies
nationwideA study shows Northeast
and less populated states
give more quality careBy Martha Irvine
Associated PressMedicare patients in the Northeast and sparsely populated states were most likely to receive appropriate treatments for such conditions.
However, those in the Southeast and more populated states were least likely to get the same treatments, according to the state-by-state comparison in today's Journal of the American Medical Association.
Hawaii was ranked No. 22 among states for quality of care.The study, based on tens of thousands of medical records from 1997 to 1999, was done by researchers at the Health Care Financing Administration, the Baltimore-based agency that administers Medicare to elderly Americans.
The researchers offered no explanation for the disparities.
"I'm delighted if this paper stimulates people in states that are ranked a little lower to try harder," said Dr. Stephen Jencks, an assistant surgeon general who also oversees HCFA's quality improvement group. "But I'm very sad if it leads people who are ranked a little higher ... to say we don't need to do anything to improve."
The states were ranked based on a total of 22 standards of care for heart attack, heart failure, stroke, pneumonia, breast cancer and diabetes.
The standards included everything from avoiding a potentially deadly treatment -- such as giving stroke victims the blood-pressure-suppressing drug nifedipine -- to educating pneumonia patients about immunization.
Of the most populated states, New York, which was 31st, fared the best. Overall, Florida finished 40th, California 41st, Texas 45th and Illinois 46th.
On the Net:
Health Care Financing Administration: http://www.hcfa.gov