Puget Sound quality project shows variation by region

By Diana Manos
09:46 AM

Puget Sound medical groups, clinics and hospitals perform among the best in the nation on some measures, while falling significantly short on others, according to the fifth Community Checkup, issued Wednesday by the Puget Sound Health Alliance.

According to the Alliance, data in the Community Checkup was supplied by 18 different organizations, including health plans, employers and labor trusts. The report was made possible by the participation of the medical groups, data suppliers and members of the Alliance board and committees who guide the process of producing the report, and by funding and technical support from the Robert Wood Johnson Foundation.

"The Community Checkup supports the change that we seek to make," said Mary McWilliams, executive director of the Alliance. "By working in our focus areas, the Alliance believes that it can achieve its strategic vision: By 2015, physicians, other providers and hospitals in the region will be in the top 10 percent in performance nationally in the delivery of quality, evidence-based care and in the reduction of unwarranted variation, resulting in a significant reduction in medical cost trends."

The Community Checkup reports on how well care is delivered at the medical group level on 23 measures of quality and appropriateness. The measures fall into areas of prevention, chronic disease management, generic drug substitution and appropriate use of services.

[See also: Puget Sound Health Alliance to coordinate quality care program using HIT.]

The report includes data on care for 1.6 million patients who are covered by commercial insurance and Medicaid managed care in the five counties in the Puget Sound region – King, Kitsap, Pierce, Snohomish and Thurston – for the period from July 2009 to June 2010.

Highlights of the report included:

  • Generic drug substitution results show the greatest amount of variation among medical groups and even within medical groups. The region continues to miss a significant savings opportunity by failing to increase the generic fill rate.
  • The region performs well on diabetes management, but even with a high performance thousands of patients did not receive the recommended care during the reporting period.
  • Regional results are disappointing for Chlamydia screening, avoiding antibiotics for bronchitis and spirometry testing for COPD. In each of these measures, fewer than half the patients received the care that they should have.
  • Hospital quality measures continue to show improvement over time, particularly for heart failure care and pneumonia care. Hospital patient experience shows the most opportunity for improvement.

In addition, the Community Checkup reports on over forty hospital measures with results being drawn from several public sources. Full results for the Community Checkup, including a downloadable report and executive summary, are available online here. 

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