NurseWeek

California ranks near bottom in care standards

By Cathryn Domrose
October 23, 2000


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Sacramento. A federal study of the quality of care provided to Medicare beneficiaries ranks California 41st among the 50 states, Puerto Rico and the District of Columbia.

The study by the U.S. Health Care Financing Administration was based on medical records from 1977 to 1999 and ranked the states based on a number of standards, including prevention and treatment for heart attacks, heart failure, breast cancer, stroke, pneumonia and diabetes.

The study, published Oct. 4 in the Journal of the American Medical Association, reviewed the traditional Medicare program for the elderly and disabled. It did not include managed care plans.

"This is a call to action," said Jane Cordingley-Klein, director of marketing and communications for CMRI, an organization that contracts with HCFA to improve the quality of care for California’s Medicare beneficiaries. "Everybody needs to focus on improving the quality of care. Often, nurses can provide leadership in having that happen."

Medicare quality was highest in the Northeast and the nation’s least populous states. States in the Southeast and more populated states had the lowest quality of care, according to the study. New York ranked 31st, Florida 40th, Texas 45th and Illinois 46th. Puerto Rico ranked last.

California fell below the median in more than half the established standards, including flu and pneumonia screening, administering beta blockers within 24 hours of admission for heart attack and annual hemoglobin tests for diabetics.

Because nothing indicates that Medicare patients are treated differently than other hospital patients, Cordingley-Klein said, the report offers a snapshot of health care in the nation.

Nearly 4 million Californians are enrolled in Medicare, making up 10 percent of the national Medicare population.