Study: Hawaii Tops the Nation in Providing Health Care

A national study says Hawaii does better than any state providing health care to its residents.

A New York-based private foundation that promotes health care compared how states measured in 32 medical areas between 2002 and 2005.

Iowa, New Hampshire, Vermont and Maine rounded out the top five, according to the Commonwealth Fund Commission on a High Performance Health System.

State officials said Hawaii did well because of the wide availability of health insurance in the islands, with most residents enrolled in employer or state programs.

Loretta Fuddy, the state Health Department’s deputy director for administration, said the state has put “real emphasis on increasing the public sector care.”

The percentage of uninsured children in the state fell to five percent in 2005 from 10 percent five years earlier, Fuddy said.

Most recently, the state Department of Human Services has expanded health coverage for Medicaid-eligible adults, including preventive dental coverage, she noted.

Increased subsidies for hospitals and community health centers further boost public access to care, she said.

Also important, Fuddy said, was Hawaii’s low unemployment rate.

Even so, Hawaii has areas where it could improve.

The state ranked 49th in the percentage of surgical patients receiving appropriately timed antibiotics to prevent infections. It was 47th in the percent of heart-failure patients given written discharge instructions.

More positively, the islands ranked fourth for avoidable hospital use and costs, eighth for healthy lives and 18th for quality of care.

“We seem to do very well with inpatient care,” said Fuddy. “We fell down in the area of patient education and hospital discharge planning and we need to look at a better job of screening and preventive care for adults over age 50.”

Lead author Joel Cantor, director of the State Health Policy Center at Rutgers University, said no state or group of states had top marks in all areas. Even the top states “aren’t doing as well as they could be” in key areas, he said.

Commonwealth Fund Senior Vice President Cathy Schoen, co-author of the report, said there were “shocking” differences between the top and bottom states.

“Where you live clearly matters — for access to care when you need it, the quality of care you receive, and opportunities to live healthier lives,” she said.