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November-December 2010 St@teside

2009 State Snapshot Shows Significant Quality of Care Improvement in Maine

The 2009 National Health Quality Report (NHQR) State Snapshots from the Agency for Healthcare Research and Quality (AHRQ) rates Maine as the fourth best performing state across all measures in overall health care. New Hampshire, Wisconsin, and Minnesota respectively claimed the first three spots, but Maine stands out due to a significant leap from the 2008 NHQR rank of 13th overall.
Some, such as Elizabeth Mitchell of the Maine Health Management Coalition, have attributed the rise of health care quality in Maine to the transparency provided by publicly reporting health care quality information. While the connection between reporting and performance is not definitive, Karen Ho, a researcher at AHRQ, notes that the five top-rated states have prioritized public reporting on health quality. This reporting provides tangible information, making it easier to understand and improve areas where there are shortcomings. Dr. Jo Linder, president of the Maine Medical Association, also emphasizes the importance of collaborative efforts.[1]  One such collaborative is the Robert Wood Johnson Foundation-sponsored Aligning Forces for Quality (AF4Q) initiative led by Quality Counts in Maine. Since 2004, the AF4Q initiative has helped coordinate existing efforts to improve quality of care in Maine through a network of 35 organizations.  
Despite the overall increase in quality of care, there is still room for improvement in Maine. The percentage of hospice patients not receiving appropriate medication for pain management, percentage of long-stay nursing home residents who lose control of their bowels or bladders, and percentage of long-stay nursing home residents who are depressed or anxious were all higher than average.[2] Clinical areas where Maine was only average include heart disease, cancer, and maternal/child health. Maine’s strongest measures included inpatient surgery categories (appropriate antibiotic timing, stoppage of antibiotics within 24 hours), dialysis categories among Medicare patients, flu shots for high risk adults with diabetes, and the utilization of fecal occult blood tests. The signs are encouraging and more states will look to what was done in Maine to improve its quality of health care.