By SHARMINA MANANDHAR
WASHINGTON (Oct. 8, 2009)—Maryland's health care delivery system slipped a notch since 2007, according to a foundation study to be released today, in part because Maryland's performance declined in some areas and in part because other states improved.
At 17th overall, Maryland placed in the top half of states with the best health care systems, according to The Commonwealth Fund. It ranked ahead of Virginia (22nd) and the District of Columbia (26th), although both jurisdictions moved up in the rankings compared to 2007.
Vermont (first), Hawaii and Iowa retained the top three spots.
The study by the Commonwealth Fund Commission, a private foundation researching health care issues since 1918, is particularly timely. The Congress is struggling to establish comprehensive health reform.
The study measured all states and the District of Columbia in more than two-dozen performance areas under the headings of access to health care, equity, healthy lives and prevention and treatment, as well as avoidable hospital use and costs of care.
The Maryland Department of Health and Mental Hygiene would not comment on Maryland's performance until the study was made publicly available.
"Maryland held fairly steady in the position in the scorecard relative to other states," said Joel Cantor, director of Rutgers University Center for State Health Policy and one of the study authors. Among the highlights of Maryland's performance, Cantor said, were that it was better than average in keeping people with chronic conditions out of hospitals; improved in the hospital admission of children with asthma by almost 21 percent; and dropping the percentage of Medicare hospital admissions with chronic conditions by 18 percent.
Among the negatives was preventing hospital readmissions.
Short-stay nursing home residents (within 30 days) were readmitted 12 percent more often, while Medicare 30-day readmission increased more than 7 percent.
Though the state's ranking in terms of prevention and treatment performance dropped to 20 from 16, it did fairly well in preventive care, according to Cantor.
The percentage of heart failure patients given written instructions at discharge increased almost 37 percent.
The state hit a middle mark on preventive care with half the state's older adult population getting recommended screening and preventive care.
But minority access to health care was a sore spot. Maryland's 46 percent uninsured minority population under age 65, was much worse than the national average of 17.5 percent. And that Maryland percentage is more than 7 percent higher than the last survey.
Maryland's congressional Democrats on Tuesday held a news conference to highlight the disparity issues in health care, based on other studies, and advocate for reforms to correct them.
Minorities in Maryland would benefit from health reform, Cantor said. The health reform would require all residents to get health insurance.
The total number of insured remained stable.
The percentage of insured adults, ages 18-64, as well as the percentage of insured children, 17 and under, increased nominally by 0.6 percent and 0.5 percent respectively.
Capital News Service contributed to this report.