Grant to Puget Sound Health Alliance will target health inequities

The Robert Wood Johnson Foundation has announced it will give the Puget Sound Health Alliance more than $1 million and significant technical assistance as part of a $300 million initiative to improve health quality in 14 communities around the country.

Too often, said Dr. Michael Painter, a senior program officer at the Foundation, patients aren't getting the care they need to avoid expensive, dangerous complications.

"Poor-quality care hurts real people and kills real people," he said. "It's an urgent problem that the country needs to face. It really isn't an abstraction."

For example, women who don't get recommended mammograms can find themselves diagnosed with late-stage breast cancer, and patients with poorly controlled diabetes could face amputation.

Researchers at the Dartmouth Institute for Health Policy and Clinical Practice, which runs the Dartmouth Atlas Project, looking at how health care is actually delivered, have discovered that such complications vary greatly by race and region. Nationally, for example, African Americans lose legs to amputations nearly five times as often as whites.

The Puget Sound region is better than average overall in the rate of leg amputation, according to the Dartmouth data. Even so, the complication occurs far more often to African-American patients than to whites. And overall, one in 10 patients with diabetes isn't getting crucial blood tests.

More than one in three women in the region insured by Medicare are not getting recommended mammograms, the researchers said.

Recent data from the Agency on Health Care Research and Quality showed that Washington state could save more than $52 million if even 10 percent of unnecessary hospitalizations were avoided. "Unnecessary," in the researchers' parlance, means hospitalizations for complications that wouldn't have happened if the patients' conditions had been managed well.

Reducing those hospitalizations by 50 percent, the researchers calculated, would bring an annual savings of $262 million — "not to mention the improvement to people's lives when they don't end up so sick that they need to be in the hospital," said Diane Giese, spokeswoman for the Puget Sound Health Alliance.

The Puget Sound Health Alliance, recipient of the $1 million grant, is a nonprofit coalition of large private and public employers, physician groups, hospitals, consumer organizations, unions, insurers, drug companies and others that has been working to improve price and quality of regional health-care delivery.

The RWJF grants aim at using such regional health-care coalitions to help bring resources, expertise and training to health providers, patients and those who pay for health care, such as businesses and insurers.

Specifically, the grant money will go toward:

• Supporting and encouraging doctors in improving care quality

• Giving patients more information to manage their own health and make informed choices

• Reducing inequalities in patient care

• Supporting hospitals in improving care, particularly focusing on the central role of nurses

Part of the project, Giese said, will be to empower front-line nurses at least one hospital to make rapid changes in patient care to improve quality.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com