Northern Kentucky hospital region’s health ranking remains below national average and Cincinnati’s

The health of the region served by Covington hospitals remained below the national average in 2014. So says data compiled by The Commonwealth Fund, a foundation that aims to promote a high performing health care system.

Covington’s ranking, at 227th of 306 hospital referral regions in the U.S., is up three spots from the region’s number in 2011, the last time The Commonwealth Fund produced its Scorecard on Local Health System Performance.

Covington is one of five hospital referral regions with its major hospitals in Kentucky. The scorecard includes measurements of health and the efficacy of hospitals and other parts of the health-care system.

St. Elizabeth Hospital Edgewood (Image from WCPO-TV)

Hospital referral regions represent regional health-care markets with at least one hospital in which complex surgeries are performed, such as St. Elizabeth Healthcare. Such hospitals are at the apex of a regional health system, which includes smaller hospitals, doctor’s offices and so on. HRRs, developed by the Dartmouth Atlas of Health Care, are widely used in health-services research and policy analysis.

Because there is relatively little difference between closely ranked regions, the rankings are also expressed as groups. Covington ranked in the next-to-bottom fifth in 2014, the same grouping it had in 2011. Also, changes in underlying data sources or definitions of measure required researchers to make some changes to their measurements, so the new scorecard shouldn’t be viewed as a precise update to the last version, The Commonwealth Fund says.

The overall rankings are divided into four dimensions: access, prevention and treatment, healthy lives and avoidable trips to the hospital (including hospital costs). Covington improved its ranking in two dimensions from 2011 to 2014, rising to 140th from 147th in 2011 in access and affordability and to 198th from 234th in prevention and treatment.

Covington’s rankings fell in the two other dimensions: to 296th from 293rd in preventable hospital visits and to 212th from 190th in healthy lives.

Factors that affect access include uninsured children and adults, adults who went without care because of cost in the past year and adults without routine doctor or dental visits. Prevention and treatment factors include instructions given to hospital patients about home recovery, adults with a regular source of care and adults with age-appropriate vaccines. Factors that influence avoidable hospital visits include Medicare hospital readmissions within 30 days and potentially avoidable emergency-room visits by Medicare patients. The “healthy lives” dimension is influenced by health outcomes such as obesity, smoking and deaths from certain types of cancers, including breast and colorectal.

Among individual health indicators, the Covington area’s numbers improved in 11 of 33 categories, including uninsured adults and adults with age-appropriate vaccines. The region’s uninsured adults dropped 4 percentage points from 2011, down to 11 percent in 2014.

Sara Collins, vice president of health care coverage and access for The Commonwealth Fund, attributes the improvement in Kentucky’s uninsured numbers to the 2014 expansion of eligibility for Medicaid and the creation of Kynect, the state health-insurance marketplace where Kentuckians enrolled for Medicaid or federally subsidized private insurance.

“I do think the decline we’re seeing [in the uninsured] is a direct result of both of those programs,” she said. “Medicaid has been a very important source of coverage for the state.”

Adapted Dartmouth Atlas map shows hospital referral regions

The region worsened in four categories, including breast cancer deaths and adults without a usual source of care.