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Thursday, July 14, 2016

Owensboro health-care region ranks as healthiest of five such regions with their major hospitals in Kentucky

By Danielle Ray
Kentucky Health News

The health of the region served by Owensboro hospitals is the best of any hospital referral region based in Kentucky. So says data compiled by The Commonwealth Fund, a foundation that aims to promote a high-performing health care system.

However, Owensboro's ranking remains lower than average, at 173rd of 306 hospital referral regions in the U.S. The ranking is also down 13 spots from Owensboro's number in 2011, the last time The Commonwealth Fund produced its Scorecard on Local Health System Performance.

Adapted Dartmouth Atlas map shows hospital referral regions
The scorecard includes measurements of health and the efficacy of hospitals and other parts of the health-care system.

Owensboro is one of five hospital referral regions with its major hospitals in Kentucky.
Hospital referral regions represent regional health-care markets with at least one hospital in which complex surgeries are performed, such as Owensboro Health Regional Hospital. Such hospitals are at the apex of a regional health system, which includes smaller hospitals, doctor's offices and so on. HRRs, developed by the Dartmouth Atlas of Health Care, are widely used in health-services research and policy analysis.

Because there is relatively little difference between closely ranked regions, the rankings are also expressed as groups. Owensboro ranked in the middle fifth in 2014, the same grouping it had in 2011. Also, changes in underlying data sources or definitions of measure required researchers to make some changes to their measurements, so the new scorecard shouldn't be viewed as a precise update to the last version, The Commonwealth Fund says.

The overall rankings are divided into four dimensions: access, prevention and treatment, healthy lives and avoidable trips to the hospital (including hospital costs). Owensboro improved its ranking in only one dimension from 2011 to 2014, rising to 92nd from 171st in 2011 in access and affordability.

Owensboro's rankings fell in all other dimensions: to 132nd from 70th in prevention and treatment; to 186th from 148th in preventable hospital visits; and to 251st from 244th in healthy lives.

Owensboro Health Regional Hospital (Owensboro Living photo)
Factors that affect access include uninsured children and adults, adults who went without care because of cost in the past year and adults without routine doctor or dental visits.

Prevention and treatment factors include instructions given to hospital patients about home recovery, adults with a regular source of care and adults with age-appropriate vaccines.

Factors that influence avoidable hospital visits include Medicare hospital readmissions and potentially avoidable emergency room visits by Medicare patients.

The "healthy lives" dimension is influenced by health outcomes such as obesity, smoking and deaths from certain types of cancers, including breast and colorectal.

In individual health indicators, Owensboro's numbers improved in 15 of 33 categories, including obesity, smoking and uninsured adults. Owensboro's uninsured adults dropped 9 percentage points from 2011, down to 10 percent in 2014.

Sara Collins, vice president of health care coverage and access for The Commonwealth Fund, attributes the improvement in Kentucky's uninsured numbers to the 2014 expansion of eligibility for Medicaid and the creation of Kynect, the state health-insurance marketplace where Kentuckians enrolled for Medicaid or federally subsidized private insurance.

"I do think the decline we’re seeing [in the uninsured] is a direct result of both of those programs," she said. "Medicaid has been a very important source of coverage for the state."

The Owensboro region worsened in eight categories, including breast cancer deaths and infant mortality.

Honolulu ranks first in the nation in performance by dimension. Paducah ranks 225th, with Covington just behind at 227th. Louisville is 233rd overall, and Lexington is at 268th. The entire interactive scorecard is available here. Much of Southern Kentucky is in the Nashville region, which ranks 245th.

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