Quality Report Shows Wide Variation in Care

Diabetes care beats national average, but chlamydia screenings fall below

September 24, 2009 -- Across Oregon, there are dangerous gaps between the health care that people should receive and the care they actually receive. That’s among the findings in a report released today by a non-profit health group on the quality of primary care in Oregon.

Information for a Healthy Oregon: Statewide Report on Health Care Quality is the most comprehensive report on the quality of primary care to date and establishes a baseline against which Oregon can measure its progress toward improving health care.
  
The report summarizes care delivered by 308 adult primary care practices in Oregon, representing a total of 2,212 primary care practitioners, or about two-thirds of the state’s adult primary care practitioners. All regions of the state are represented, with 62 percent of practices located outside the Portland metropolitan area.
  
The Oregon Health Care Quality Corporation is part of the Robert Wood Johnson Foundation’s _Aligning Forces for Quality_ initiative, a pilot program in 15 communities across the United States to lift the overall quality of care.
  
The non-profit partnership includes doctors, hospitals, insurers, providers, purchasers, government agencies, and consumers, and is dedicated to improving the quality of health care in Oregon through better information and increased collaboration.
  
“Every health reform proposal on the table requires measurement of health care quality and value,” said Nancy Clarke, executive director of the Oregon Health Care Quality Corporation. “Now that we’ve built a collaborative system for measuring quality, we can see that care really does vary. We can also see that the data are better when we work together.”

While the report illustrates areas of care that Oregon can be proud of, as well as important opportunities for improvement, other measures clearly need attention. Key findings follow:

DIABETES CARE EXCEEDS NATIONAL AVERAGE
On average, primary care practices in Oregon are assuring that over 80 percent of patients with diabetes have their blood sugar control checked at least once a year. Rates for patients with diabetes receiving annual eye exams and kidney disease screenings are better than the top 10 percent of health plans nationwide, though the rate for eye exam still shows room for improvement.
 
MIXED RESULTS FOR WOMEN’S PREVENTIVE HEALTH SCREENINGS
In stark contrast to high rates of preventive screening for breast cancer and cervical cancer, rates for Chlamydia screening are lower than the national average. More than 70 percent of women needing the screening and who visited a practitioner did not receive the test.
 
QUALITY PERFORMANCE VARIES
There are large differences between the lowest and highest performing primary care practices in Oregon. For example, the difference between the lowest and highest score for Chlamydia screening is over 70 percentage points. The difference between the lowest and highest scores are over 20 percentage points for asthma medication and over 35 percentage points for heart disease testing.
 
HEALTH CARE QUALITY BY REGION
Practices in the South Coast region have the highest levels of Chlamydia and breast cancer screening. For diabetes measures, the more urban areas of the state, and especially Portland Metro, have better scores on average. Nonetheless, some less dense population areas, like Central Oregon, have above average scores on diabetes measures.
 
Report data comes from administrative claims of eight of Oregon’s largest health plans, representing care given to nearly half of Oregon’s patients during 2007. In early 2010, information on individual primary care practices will be available.
 
“This report is important reading for anyone who gets, gives or pays for care in Oregon to make informed choices and improve local health care,” said Susan Mende, M.P.H., senior program officer at the Robert Wood Johnson Foundation, which helped fund the report through its _Aligning Forces for Quality_ program. “It has established the Oregon Health Care Quality Corporation as a leader in a national movement to improve the quality of care.”
 
For more information, including a copy of the report, visit www.partnerforqualitycare.org.