A recent article ("Top marks for state in elderly care," Sept. 8) gave mixed reviews to Minnesota's home health industry. It listed some quality measures that seem to indicate that home care in Minnesota is below the national averages, but omitted those that show the state equal to or outpacing national averages.

One example was the citation that Minnesota ranks 48th in terms of private-pay cost. There are many factors that contribute to higher costs for this care in our state, one of which is salaries and benefits.

However, the data in the article do not cite actual private-pay usage. Many home care clients do not pay out of pocket for home care; rather, they are aided by community-based, community-funded programs and by county and state sources.

Another area cited as an example where Minnesota lags in home health care was the percentage of episodes in which interventions to prevent pressure sores were included in the plan for at-risk patients.

However, a better measure of actual care quality is the development of pressure sores while receiving home care. Minnesota is equal to the national average in this measure.

Last, the article reported that the percentage of patients readmitted to hospitals from home care puts Minnesota at 37th in the country. An increased rehospitalization rate may be linked to expedited hospital discharges.

Shorter hospital stays lead to higher readmission rates from all discharge destinations, including skilled nursing facilities, transitional-care units and home care. Moreover, the federal government's Home Health Compare website puts Minnesota on equal footing with the national average at 26 percent.

Minnesota is equal to the national average for many quality measures, including how often patients got better at getting out of bed and how often the home health team treated for heart failure.

The state is far above the national average in terms of flu shots and pneumonia vaccines -- by 15 and 18 percentage points, respectively. If this is indicative of anything, it is that Minnesota home care agencies are committed to preserving the health of their patients and the public.

The article states that "as many as 200,000 people could be kept out of nursing homes each year if other states emulated Minnesota with better information about home care options." Clearly, Minnesota home care is doing something right.

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Elizabeth Sowden is communications manager of the Minnesota HomeCare Association.