In the United States, where a person lives determines the kind of health care available and the length and quality of life a person is likely to enjoy. The 2014 edition of The Commonwealth Fund's Scorecard on State Health System Performance documents persistently wide geographic disparities, with some states consistently performing better than others on the scorecard's 42 indicators of health care access, quality, efficiency, and outcomes (eFigure 1 in Supplement shows the 50 states and the District of Columbia ranked by quartile on a composite score aggregated from the 42 indicators of health system performance, using the most recently available data typically representing the year 2011 or 2012, or both).
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