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Quality of Maryland's health care gets mixed reviews

April 18, 2010|By TIFFANY MARCH

WASHINGTON -- Maryland excels in some areas of health care, such as breast cancer screening and in-home care, but lags in others, such as pneumonia treatment and the number of HIV-related deaths, according to a new study.

The National Healthcare Quality Report, released last week, is an annual checkup on the quality of health care across the country, first ordered by Congress in 2003.

Overall, the quality of Maryland's health care falls between weak and average, according to the agency that publishes the report, the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality.

Karen Migdail, a spokeswoman for the agency, said Maryland's results are not unusual.

"Most states have mixed results; they don't do well on everything or poorly on everything," Migdail said.

Health care experts and advocates said Maryland has a solid system, and blamed the weak areas on the state's budget constraints and physician shortage.

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"As society takes stumbles, health care takes stumbles," said W. James Reiter, vice president for communications at the Maryland Hospital Association. "Overall, it's a very good system."

Besides high marks in breast cancer screening for women older than 40, Maryland has a low rate of suicide deaths and excels in proper care for heart attack patients. Maryland is in the highest 25 percent of states for adult home health care patients whose ability to walk or move around has improved.

Maryland falls below average in HIV-infection deaths per 100,000 people and in providing recommended pneumonia care.

William Honablew Jr., chief of policy and public information for Maryland's Infectious Disease and Environmental Health Administration, acknowledged the HIV-death rate is high. But he said it has decreased -- from nearly 1,600 in 1995 to fewer than 500 in 2006 -- because of better medical treatment and earlier screening for high-risk patients.

The lack of care for pneumonia patients might be because the state faces a major physician shortage, said Gene Ransom, CEO of the state's medical society, MedChi. Pneumonia is usually treated by primary care physicians, who are in high demand, he said.

"When you have these shortages, it's going to result in a weakening of the quality of care in some cases," Ransom said.

Other data from the Maryland Hospital Association shows Maryland is about average in the nation for properly treating pneumonia patients, and the 2008 National Healthcare Quality Report said Maryland was average in giving pneumonia vaccinations to adults 65 and older.

In many other health care areas, the report showed Maryland on par with or slightly above the national average, including giving appropriate antibiotics to surgery patients and using physical restraints for nursing home residents.

Maryland is even with or slightly below the national average in providing coordinated care for children with special needs, and registering dialysis patients on a waiting list for kidney transplants.

The national health care agency created state profiles, which show that Maryland is behind neighbors Virginia, Delaware, New Jersey and Pennsylvania, and is below average nationally. The profiles also show Maryland's health care quality declined from 2006 to 2008.

Additionally, Maryland's profile shows there is a serious gap in the quality of health care that high-income ($61,000 and above) and low-income ($36,999 and below) residents receive, compared to the national average. The gap in the disparity of quality of care for whites and blacks is small, and there is virtually no gap between quality of care for Hispanics and whites.

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