Report shows modest gains last year in quality care for patients

WILLMAR -- Local medical groups continued to see modest gains last year in 12 quality measures ranging from diabetes management to children's immunizations.

WILLMAR -- Local medical groups continued to see modest gains last year in 12 quality measures ranging from diabetes management to children's immunizations.

Affiliated Community Medical Centers and Family Practice Medical Center also earned two three-star ratings apiece for scoring above the state average on certain measures.

The report was released Thursday by Minnesota Community Measurement.

It rates the health care delivered in 2006 by 128 medical groups. The ratings can be found at the Minnesota Community Measurement Web site, . Copies of the written report can be downloaded from the site starting Dec. 3.

It's a chance for medical groups -- as well as the public -- to see how they stack up against the standard of care in key areas such as health screenings and chronic disease management.


The data are collected from health plan claims and patient chart reviews

"The goal is to improve care for all patients, hopefully across the whole state. The general level across the state has improved in many of these areas," said Dr. Burnell J. Mellema, medical director for care improvement at Willmar-based Affiliated Community Medical Centers.

For instance, Affiliated was able to boost its level of appropriate asthma medication management to 94 percent. At Family Practice Medical Center in Willmar, children were being appropriately treated for colds 85 percent of the time.

Affiliated earned a three-star above-average rating on two measures: children's immunizations and breast cancer screening for women.

Family Practice Medical Center earned three-star ratings for optimal diabetes care and for appropriate evaluation of sore throats among children.

Statewide, however, the results were described by Jim Chase, executive director of Minnesota Community Measurement, as "status quo."

Chase said there were slight increases in some measures of quality care and slight decreases in others.

"This should be a wake-up call to medical providers, payers, purchasers and patients. We must all put more energy and resources into making health care better," he said.


Care continues to vary -- sometimes significantly -- from one medical group to the next, Chase said.

The percentage of children aged 2 to 18 with sore throats who received a strep test and were appropriately given an antibiotic ranged from 99 percent at the highest-performing medical group to 26 percent at the lowest.

Even the measure with the smallest range of variation, optimal diabetes care, had a 19 percentage-point spread, from 20 percent to 1 percent.

In the four years that Minnesota Community Measurement has been tracking the data, the range between the best- and lowest-performing medical groups hasn't changed, Chase said.

"Our findings point to a need to redesign the health care system to unleash its full potential to give the best quality and value to all patients, as well as to provide more support to medical groups that aren't performing well," he said.

Mellema said it's a continual challenge for medical groups to be diligent and consistent at meeting the standards.

"I think that the attention to these measures does increase the efforts of the providers to improve," he said. "Care is complex, and unless we have a system to make sure it happens every time, it may not."

One drawback of the community measurement report is its relatively small sample size -- typically 60 to 100 patients for each of the 12 standards.


For its internal audits, Affiliated generally reviews more than 1,000 charts, Mellema said. "Sample size and random selection do affect results," he said.

Data collection is expected to improve as more medical groups adopt electronic health records. Family Practice Medical Center already maintains electronic records on all its patients. Affiliated is in the process of moving toward a paperless system at all nine of its regional multi-specialty clinics.

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