Abstract

This report examines variations among states’ child health care systems, building on the State Scorecard published by The Commonwealth Fund Commission on a High Performance Health System. Focusing on 13 performance indicators of access, quality, costs, equity, and the potential to lead healthy lives, the authors find wide variation among states, including distinct regional patterns. Across states, better access to care is closely associated with better quality of care. Top-performing states, such as Iowa and Vermont, have adopted policies to expand children’s access to care and improve the quality of care. While leading states outperform lagging states on multiple indicators, all states have opportunities to improve. National leadership and collaboration across public and private sectors are essential for coherent, strategic reforms to improve child health care in the United States. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. This and other Fund publications are available online at www.commonwealthfund.org. To learn more about new publications when they become available, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 1140. Note: Portions of this report were revised as of June 6, 2008.

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