Utah's right in the middle of the pack when it comes to children's health care — best in the nation in terms of personal health spending per capita, among the worst for access and having a medical home. Its overall rank is 26, according to the Commonwealth Fund's just-released "scorecard" that looked at children's health on such measures as access, quality, equity and the potential to lead long, healthy, productive lives.

On that last measure, Utah tied with New Hampshire for No. 3, bested only by Vermont and Maine. And the Beehive State is No. 4 in the number of hospital admissions for pediatric asthma, at 91.8 per 100,000. It ranked No. 4, as well, in terms of the percent of children ages 1 to 5 at moderate or high risk for developmental delay.

Utah tied for second-best in terms of family costs of health care. But on other marks, it didn't fare so well. For instance, the report ranked Utah 39 on both quality and equity. The quality measures include getting the right care, coordinated care and family-centered care.

The state's other top-10 ranking was in infant mortality, at No. 8, with 5.6 per 1,000 live births.

Utah's best ranking, the per capita personal health care spending, was $3,972 in 2004, while spending in Washington, D.C., which came in dead last, was $8,295.

Overall, Iowa and Vermont scored highest in the report.

Investing in and improving children's health has long-term payoffs, said Dr. Edward L. Schor, CF vice president over child development and preventive care. "They reach school ready and able to learn," they thrive and become healthy adults.

States look different in their rankings for children's health than they did when measured for health overall in earlier Commonwealth and other reports that took data on Medicare beneficiaries, according to Karen Davis, president of the organization. It's harder to look at health care spending for children, since no direct data is available, she said. They had to look at less direct information, such as family health insurance premiums and overall health spending per capita.

The researchers found that states that did well in terms of access to care also did well in terms of quality of care, Schor said.

During a pre-release media briefing, Schor and Davis said that if all states performed like the best-ranked states, 4.6 million more children would have health insurance coverage, almost 757,000 more children 19-35 moths old would be current on their recommended vaccines, 11.7 million more children would have a medical and dental preventive care visit each year, nearly 11 million more children would have a "medical home" and nearly 413,000 fewer children with special health care needs would have trouble obtaining referrals to specialty-care services. Besides that, they noted, 1.6 million fewer children ages 1 to 5 would be at risk of developmental delays.

The report is online at commonwealthfund.org.

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E-mail: lois@desnews.com