Medicare's Badlands Of Preventive Care: Chicago, McAllen And The Bronx

The Dartmouth Atlas of Health Care can always be counted on to highlight unusual Medicare trends in often obscure parts of the country.

The latest report released today is no exception, with some fascinating findings on mammograms, leg amputations and racial disparities in visiting primary care docs.

Remember that the Dartmouth folks, whose work studying regional variation in health care spending has influenced the Obama administration, look only at Medicare enrollees, not the entire population, in their annual Atlases.

Leg amputation capital of the country: McAllen, Texas (3.29 per 1,000 —  paging Dr. Gawande!).

Medicare recipients least likely to lose a leg: Provo, Utah (0.33 amputations per 1,000—good news since they’re most likely to undergo shoulder surgery there).

Highest rate of visiting a primary care clinician at least once a year: Florence, S.C.  (88 percent).

Lowest rate of seeing a primary care clinician at least once a year: Bronx, N.Y.  (60.2 percent).

Blacks most likely to see a primary care clinician at least once a year: Waterloo, Iowa  (88.7 percent -- even more than whites).

Blacks least likely to see a primary care clinician: Olympia, Wash. (42.9 percent, half the rate of whites there).

Highest mammogram rate: Traverse City, Mich. (76.1 percent of females age 67-69 got at least one mammogram in a two-year period).

Lowest mammogram rate: Chicago.  (50.1 percent —  potential campaign issue for a mayoral candidate?).

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