Medical care varies widely at area clinics and hospitals

A new report shows the quality of medical care varies widely at clinics and hospitals across the Puget Sound region, with many patients failing to get basic treatment recommended by national guidelines.

Nearly half of clinics surveyed were below average at ensuring patients with diabetes got regular eye exams to detect vision problems caused by the disease. The percentage of heart-surgery patients who received standard treatment to prevent blood clots ranged from 59 percent to 96 percent at area hospitals. And at some clinics, fewer than one in four sexually active young women were screened for chlamydia, a bacterial infection that can cause infertility and other complications.

"We definitely all have room to improve in some areas," said Dr. David Fleming, director of Public Health — Seattle and King County, and board chairman of the Puget Sound Health Alliance, which released the "Community Checkup" report Thursday. The alliance is made up of more than 160 organizations, including major employers such as Boeing and Starbucks, health insurers, city and county governments and medical providers.

Area clinics scored high on several measures, including treatment of the common cold: About 94 percent of children seen for sniffles were not given antibiotics, considered the proper course of action since the drugs do not kill the cold virus and overuse leads to antibiotic resistance. Nearly 90 percent of patients with asthma were prescribed long-term medications to control their condition.

The report used health-insurance-billing data from 1.6 million area residents to compare the treatment patients received at 46 medical groups and all 170 clinics in the region with six or more doctors. Federal data were used to measure performance at 30 area hospitals. Collectively, the survey covers about 70 percent of primary-care doctors in King, Pierce, Snohomish, Thurston and Kitsap counties.

The yardsticks used for comparison are common standards of care known to be effective in treating conditions such as diabetes, asthma and heart disease. Health-care providers were also scored on their diligence in screening for breast, colon and cervical cancer. Results for each facility or group are compared with regional averages.

Most of the data collected are available online at www.WACommunityCheckup.org, allowing consumers to see how medical groups, clinics and hospitals stack up. "All of us have problems assessing the quality of health care," Fleming said. "The report is designed to enable consumers to find that information."

Alliance members said the hope is that the report will spur improvements in health care while also cutting costs by increasing preventive care and boosting use of cheaper generic drugs.

"The overall effect is to raise the bar for everyone and to get groups to talk to each other about how to improve," said Mary McWilliams, executive director for Puget Sound Health Alliance.

Numbers are the best way to get doctors' attention, said Andrew Baron, of MultiCare Medical Group in Tacoma. A trial version of the checkup report issued last year showed that MultiCare was falling short on cervical-cancer screening rates, he said. As a result, the company is working to raise those numbers.

The alliance also gathered data on individual doctors, but that information is only available within medical groups, not to the general public. Future reports may contain some of it, McWilliams said.

Sandi Doughton: 206-464-2491

or sdoughton@seattletimes.com