Medicare patients are getting better treatment than they did a few years ago for such ailments as heart attacks, pneumonia, breast cancer and diabetes, but the quality of care still varies widely by region and state, a government report card says.
The study is an update of a government report on patients treated in 1998-99. The new figures cover 2000-01.
The proportion of Medicare patients receiving appropriate care increased to 73.4% from 69.5%. On average, states improved on 20 of 22 quality indicators.
Among the biggest gains were those made in the percentage of heart attack patients being sent home from the hospital with prescriptions for beta blocker drugs; that figure rose on average to 79% rom 72%.
Another notable improvement was in the percentage of Medicare patients receiving pneumococcal vaccines -- up to 65% from 55%.
"This report shows we're making important progress on quality health-care delivery," said Health and Human Services Secretary Tommy G. Thompson.
Nonetheless, substantial numbers still are not getting the vaccine, which is recommended for adults 65 and older to prevent pneumonia, said study leader Dr. Stephen Jencks, director of the quality improvement group at the Centers for Medicare & Medicaid Services.
The centers administer Medicare services for the nation's elderly.
"All you have to do is give the darn vaccine, you can give it any time of year, there isn't a shortage, and we're still not there," Jencks said. "Health-care systems are still far too tuned to treating the acute illness rather than prevention."
The findings "are encouraging in showing that improvement is possible and is taking place," the authors said. "They should not lead to complacency: There is still a very long way to go, and medicine is changing at least as fast as our progress in implementing what was the standard of care just a few years ago."
The study appears in today's Journal of the American Medical Assn.
Other gains included the percentages of patients receiving annual mammograms, eye exams for diabetics and flu shots.