RIAFP Policy
Brief: 10/5/00
Improving the Quality of Care Provided To Rhode
Islanders
An important
paper published in today's Journal
of the American Medical Association provides a glimpse of the
quality of care Rhode Islanders receive, as the study looks at state-by-state
variations in the performance of a number of measurable outcomes for
Medicare recipients in 1997 and 1998.
All other New
England states ranked in the top six states for quality as defined
by these measures. Rhode Island ranked 24th overall, and was
the only New England state to rank below the top six states.
Rhode Island
ranked lowest in hospital smoking cessation counseling (48th), hospital
administration of antibiotics for pneumonia within eight hours (44th),
and inpatient documentation of influenza and pneumonia vaccine. There
were significant areas of improvement needed in our mammography rate
(17th), statewide influenza and pneumocccal vaccine rates (20 and
35th), and routine diabetes care. (26th and 35th).
The study also
does not reflect Rhode IslandÕs national leadership in childhood immunization.
This study does
discuss that in 1997, Rhode Island was the 6th most expensive state
for Medicare recipients.
These measures
and this performance reflect the overloading of our emergency room
(delaying the prompt administration of antibiotics for pneumonia)
and inadequate access to and use of primary care in Rhode Island.
For many years,
the Rhode Island primary community has practiced with reimbursement
10 to 20 percent less than surrounding states (and 4 to 7 percent
less for Medicare). That chronic under funding has prevented the development
of a strong primary care infrastructure, and prevented the development
of strong primary care practices that can see people the same day
they are ill and thus take the load off emergency rooms, that can
immunize both children and adults, order mammograms, adequately treat
diabetes, and put prevention first.
Counseling by
primary care physicians is the most effective method of helping
people stop smoking.
Family physicians
are the cornerstone of effective and efficient health care
systems all around the world.
Only seven
percent of Rhode Island Physicians are Family Physicians, which
make us 45th in the nation for the percentage of our physicians
who are family physicians. Family physicians see people when they
are ill, immunize children and adults, order mammograms, treat diabetes
Ð and are well equipped, given an adequate infrastructure, to put
prevention first.
We can, and must,
do better.
This is one
in a series of reports designed to advance Family Practice and primary
care in Rhode Island's health care system, as well as to discuss public
health issues of importance to all Rhode Islanders.
We welcome
the opportunity to further discuss the issues presented here. We can
be reached by phone at 401-453-4176, or by email at info@riafp.org.
10/5/00
