Thursday, May 29, 2008

Kids Care, A Report Card

The subtitle of today's article du jour is, "Those that have the most access to insurance tend to have healthier children." This is hardly a shocking observation. What is shocking are the grades given to the various states of the U.S. by the Commonwealth Fund in their recent report U.S. Variations on Child Health System Performance: A State Scorecard. Steve Reinberg, HealthDay reporter for US News and World Report takes a look at the results:

According to the scorecard, if all states performed as well as the top few states:

  • an additional 4.6 million children nationwide would have health insurance;
  • 11.8 million more children would get their recommended yearly medical and dental check-ups;
  • 10.9 million more children would have a "medical home" -- a regular source of care;
  • 1.6 million fewer children would be at risk for developmental delays;
  • and nearly 800,000 more children would be up-to-date on their vaccines.

Iowa, Vermont, Maine, Massachusetts, and New Hampshire are the top performing states, according to the report, while Arizona, Florida, Louisiana, Mississippi, New Jersey, Nevada and Texas are at the bottom.

As a Louisiana native, this is far from welcome, although unsurprising, news. With fifty states in the Union there are fifty different sets of standards being applied leading to a broad variance in results. Commonwealth Fund President Karen Davis stated in a Tuesday teleconference that more than a full third of American children receive care due to funding from the Federal Government and the states. SCHIP and Medicare were cited as crucial components in delivery of that care.

The scorecard took into account 13 indicators of children's health, including access, quality, costs, equity and the potential to lead a long and healthy life. While no state scored high on all categories, some regions surpassed others. For example, states in the Northeast and Upper Midwest often ranked higher in several areas, while the lowest rankings were in the South and Southwest, the report found.

Studies have shown that in states with high numbers of uninsured children, those children are less likely to get recommended health care, vaccines, dental care and regular checkups. These children are also at greater risk for developmental delays and infant mortality, Davis said.

But even in the highest-ranking states, quality of care falls short of goals, the report noted. In Massachusetts, the top-ranked state in quality, 75 percent of the children were seen by a doctor and a dentist in the past year, compared with only 46 percent of children in Idaho.

The conclusions reached by Davis, as related by Mr. Reinberg, are that states that do a better job of insuring their children, particularly those of low income, are among the most highly ranked overall for quality of care in the report.

For those who do not have the time or desire to dig into the actual report itself, Mr. Reinberg does a fine job of communicating the high points. The rest of his article covers comparisons of the highest and lowest ranking states, the concept of the "medical home," and more. Once again we find that the actual statistics of the current crisis in care are disheartening, but defining a problem is the first step towards rectifying it.

Continued studies such as these will help us to refine our focus on what areas need to change and how to properly go about it. We can create a system of universal care in this country. To paraphrase a line from an old television show, "We can rebuild it, make it better than it was. Better. Stronger. Faster."

SOURCE: "AStates' Scorecard Finds Big Differences in Kids' Health Care" 05/28/08
photo courtesy of M@rg, used under its Creative Commons license

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