How's our collective health?
A new diagnosis from Missouri Hospital Association (MHA) offers both good news and bad.
Let's begin with the positive.
Preventable hospital admissions dropped 18.8 percent during the decade from 2003-13, according to MHA.
Preventable admissions are acute or chronic conditions where good outpatient care may prevent hospitalization or where early intervention may prevent complications or more serious illnesses.
The decline is reflected in a cost savings estimated by MHA at $2.4 billion during the decade.
"Unfortunately," said MHA President Herb B. Kuhn, "Missouri's poor health status, health disparities, access to primary care and high uninsured rates have limited the capacity to reduce these admissions."
Missouri's health status is ranked by the United Health Foundation at 42nd, or eighth lowest in the nation.
The three most common conditions - which account for 61 percent of preventable admissions - are chronic heart failure, bacterial pneumonia and chronic obstructive pulmonary diseases.
In Missouri, these conditions exceed national averages by the following percentages: heart failure, 12 percent; bacterial pneumonia, 24 percent; pulmonary disease, 140 percent.
What can be done?
"It is possible," Kuhn said, " to significantly decrease the rate of preventable hospitalizations by addressing the conditions that lead to these admissions."
But, Kuhn cautioned, the remedy is neither singular nor simple. He attributes the admissions to "a complex and often interrelated set of circumstances" that include poverty, education, access to health services and geography.
That complexity will be apparent in the coming weeks and months with the implementation of the federal Affordable Care Act and anticipated debate on Medicaid expansion when Missouri lawmakers convene in January.