The Quality of Preventive and Diagnostic Medical Care: Why Do Southern States Underperform?

Brian S. Armour and M. Melinda Pitts
Economic Review, Vol. 90, No. 1, 2005

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As the cost of health care increases rapidly, the health care industry has turned its attention to methods of cost containment. However, concern exists that the drive to contain costs could lead to compromises in the quality of medical care. One practice that may slow the growth rate of health care expenditures and improve morbidity and mortality rates is the widespread use of preventive and diagnostic services.

Using data compiled by the Centers for Medicare and Medicaid Services, this article evaluates the quality of care received by Medicare beneficiaries in each state. The authors examine states' use of preventive services (influenza and pneumococcal immunizations) and diagnostic services (mammograms and diabetes screening tests) among Medicare beneficiaries.

The analysis points out regional differences in preventive and diagnostic care across the United States. The West has higher levels of preventive care while the Northeast has higher scores for diagnostic care. But the South had the lowest average score for quality of care in both categories. The authors attribute differences among states' levels of preventive and diagnostic care to their socioeconomic and demographic characteristics, noting in particular that the percentage of a state's Medicare population that is black is inversely related to the quality of medical care.

A better understanding of the causes behind racial disparities in the quality of medical care, the authors conclude, will promote the delivery of the highest quality of care to all Medicare beneficiaries and slow the growth rate of health care costs.

March 2005