No state received the highest rating of "very strong."

That is the result of a new health care report released by the Utah Health Data Committee. The committee directs a statewide effort to collect, analyze and distribute health care data.

The report shows that Utah's overall hospital care and chronic care ranked "strong" and home health care ranked "very strong." The state is also referred to as a "pioneer" in patient safety improvement.

However, several quality measures for preventive care in Utah are lower than national standards, including primary care visits for children, adolescent well-care and immunizations, and screenings for cervical cancer, breast cancer, colorectal cancer and chlamydia (see chart).

The study is broken into three categories: Quality and patient safety, access and cost.

Quality and safety

Public reporting on quality and safety helped increase hospital performance. But nursing home care quality was weaker than hospital or home health care.

Nursing home care was found to be substandard in five categories, including patients who were depressed or anxious and patients who were physically restrained, the report states.

There were problems for the kids, too.

"Utah faces huge challenges in promotion of preventive care," the report states.

Many children and adolescents were missing primary care visits, well-care exams and immunizations (See chart).

Terry Haven, the project director of Utah Kids Count, said part of the problem may lie with the Children's Health Insurance Program (CHIP) being overwhelmed.

Under the program, the federal government gives the state $4 for every dollar Utah spends to provide health care to the children of parents who don't qualify for Medicaid and can't afford to buy their own insurance, she said. When there is money to fund the program, it works well, she said. But the program's budget frequently runs dry and has closed the program several times in the past three years. This sometimes discourages parents from seeking preventive health care and immunizations for their kids.

Currently, CHIP is not being funded. But the program is expected to be up and running again in July, Haven said.

Access

Under the category of access, Utah children with chronic medical conditions that require special care are at a higher risk of being underserved, the report states.

About 80 percent of parents said obtaining necessary care for their children with chronic conditions was "Not a problem" in 2004. In 2006, only 71 percent said so, the report states.

Those same parents reported their satisfaction with health care declined from 93 percent to 83 percent during the same years, according to the report, and health plan satisfaction dropped from 81 percent to 56 percent.

According to the United Health Foundation's America's Health Rankings, Utah was the sixth healthiest state. But it ranked 34th in providing health insurance in the U.S.

Cost

Utah saw its rate of uninsured patients increase from 10.2 percent in 2005 to 11.6 percent in 2006. An estimated 292,800 Utahns were without health insurance in 2005. Uninsured people seeking aid in emergency rooms from 1997 to 2005 also increased.

"Persons with health insurance were more likely than persons without health insurance to have a regular source of primary health care, and were more likely to have routine preventive care," the report states.

"Persons without coverage have often delayed seeking needed care and found service difficult to afford."

Under the category of cost, Utah's health care expenditures from 1980 to 2004 rose 9.7 percent, which is higher than the national average of 8.6 percent.

But the increase was appropriate, the report states.

Utah had a lower median charge for hospital admissions ($6,416) than Arizona ($13,427), Colorado ($12,623) and Nevada ($16,939) in 2005.

Utah did make strides in switching from brand name prescription drugs to lower-costing generic drugs.

Though, between 1980 and 2004, the highest percentage jump in personal health care costs was in the prescription drug category.

The total amount of hospital services costs also increased more than two-fold from about $1.7 million in 1997 to $3.5 million in 2005, the report states.

jbergreen@sltrib.com