New Hampshire

New Hampshire spends more money per capita on healthcare than most states, and costs keep climbing.

• New Hampshire spent about $7 billion on healthcare in 2004.[1] New Hampshire’s healthcare bill keeps going up, at an 8% average annual increase between 1991 and 2004.[2]
• New Hampshire spent more on healthcare per capita in 2004 ($5,432) than the national average ($5,283).[3]
• Workers in New Hampshire purchasing employee-only coverage contribute 23% ($965), much higher than the 18% ($723) average across the country. Employers in New Hampshire pay 77% of the premium ($3,210), less than the national average of 82% ($3,268).[4]
• Family health insurance premiums cost employees more ($2,882 out-of-pocket compared to $2,585 on average nationally).[5]
• Between 2002 and 2005, family premiums in New Hampshire increased 12.7%, while median earnings of people purchasing family coverage declined by 1 percent.[6]
• People who buy health insurance through their small business cannot be excluded due to health condition, and costs are spread as widely as possible through community rating.[7]
• However, people trying to buy insurance on the individual market can be denied due to health condition. They may consider applying for health insurance under the state’s high risk pool program,[8] or if self-employed, they may enroll in a small group plan, during open enrollment, two months out of the year.[9]
• Medicaid was the state’s largest budget item at $800 million in 2004 and, without changes, is expected to grow to $1.96 billion by 2014.[10]

Despite higher costs, too many patients in New Hampshire are injured by unsafe care.

• An estimated 6,000 to 13,000 people in New Hampshire admitted to the hospital in 2006 suffered an infection due to their medical care. Hospital infections can cause permanent disability or death.[11]
• Although the true number of patients harmed by medical errors in each state is a well-kept secret, the Institute of Medicine estimates as many as 98,000 Americans die from these preventable mistakes each year. These errors range from giving the wrong medication to doing surgery on the wrong part of the body, transfusion errors and more.[12]
• A higher percentage of mothers are injured while giving birth in the hospital.[13]

New Hampshire delivers strong preventative care, particularly for diabetes, heart, and respiratory disease.

• People with diabetes get a flu shot in New Hampshire at higher rates than they do on average elsewhere (56% compared to 36% nationally). Also, they receive eye and foot exams at a higher rate than average in other states which helps diabetes patients get necessary treatment before their condition worsens. Relatively few people are hospitalized due to their diabetes.[14]
• A higher share of heart patients in New Hampshire are given necessary medical treatments that help stabilize heart attacks compared to the average across the country.[15]
• People at high risk for developing respiratory disease are getting respiratory vaccinations in New Hampshire at a higher rate than the national average. Likewise, asthma patients in New Hampshire go to the hospital less often than asthma patients elsewhere.[16]

But New Hampshire faces challenges.

• 11% of New Hampshire residents (nearly 138,000 people) remain uninsured.[17]
• New Hampshire had a higher incidence of cancer than the rest of the nation (488 per 100,000 New Hampshire residents compared to 460 nationwide) in 2003.[18]
• While New Hampshire seniors living in nursing homes are more likely to get flu shots and less likely to be physically restrained or have bed sores, the state’s nursing homes scored worse than the national average on important quality of care measures such as help with daily activities, worsened mobility, depression and incontinence. Further, New Hampshire facilities are more likely to leave urinary catheters in patients too long, which puts them at high risk of infection.[19]

Footnotes:

[1] http://www.statehealthfacts.org/profileind.jsp?ind=592&cat=5&rgn=31

[2] http://www.statehealthfacts.org/profileind.jsp?ind=595&cat=5&rgn=31

[3] http://www.statehealthfacts.org/profileind.jsp?ind=596&cat=5&rgn=31

[4] http://www.statehealthfacts.org/profileind.jsp?cat=5&sub=67&rgn=31

[5] http://www.statehealthfacts.org/profileind.jsp?cat=5&sub=67&rgn=31

[6] http://www.rwjf.org/files/research/042508ctuwfinalembargoed.pdf

[7] http://www.statehealthfacts.org/profileind.jsp?cat=7&sub=86&rgn=31

[8] http://www.statehealthfacts.org/profileind.jsp?cat=7&sub=87&rgn=31

[9] http://www.statehealthfacts.org/profileind.jsp?cat=7&sub=86&rgn=31

[10] Stephen, John A., ‘GraniteCare: Recommendations to Modernize Medicaid,’® New Hampshire Department of Health and Human Services, 10 Nov. 2004.

[11] Infection Control ‘A Problem for Patient Safety, John P. Burke, The New England Journal of Medicine, 13 February 2003, Vol. 348: 651-656. An estimated 5 to 10 percent of all hospital patients acquire infections. In 2006, New Hampshire had 126, 364 discharges. http://hcupnet.ahrq.gov/HCUPnet.jsp; According to the CDC, hospital acquired infections are a significant cause of morbidity and mortality in the U.S. http://www.cdc.gov/ncidod/dhqp/pdf/hicpac/infections_deaths.pdf

[12] Institute of Medicine, To Err is Human, Kohn, Linda, Corrigan and Donaldson, 2000, pp.26, 35.

[13] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=NH&level=5&region=0&compGroup=N

[14] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=NH&level=7&region=0&compGroup=N

[15] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=NH&level=5&region=0&compGroup=N

[16] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=NH&level=1&region=0&compGroup=N; http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=NH&level=7&region=0&compGroup=N

[17] http://www.statehealthfacts.org/profileind.jsp?ind=125&cat=3&rgn=31

[18] http://www.statehealthfacts.org/profileind.jsp?cat=2&sub=21&rgn=31

[19] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=NH&level=6&region=0&compGroup=N ; http://www.cdc.gov/ncidod/dhqp/gl_catheter_assoc.html#