RALEIGH, N.C. — More than 40 million Americans, including 1 million North Carolinians, rely on

Medicare

for health care, but lately, any news about Medicare has been bad news.

"We've had a lot of bad news about quality over the last few years," said Dr. Stephen Jencks with the

Centers for Medicare & Medicaid Services

.

However, a study in the Jan. 14 issue of the

Journal of the American Medical Association

showed that Medicare patients are receiving better care these days.

Researchers analyzed Medicare records from every U.S. state and compared the quality of patient care.

They studied patients who were treated for breast cancer, diabetes, heart problems, pneumonia and stroke.

Research showed that in 1998 and 1999, 69 percent of Medicare patients received appropriate care. Between 2000 and 2001, the numbers rose to 73 percent.

"That sounds like a small difference, but it is a huge difference to achieve that nationwide in just two years," said Jencks.

However, Jencks said Medicare's work is not finished.

"I would hate to see people say, 'Ah, well, things are getting better so we don't need to work on them as hard,'" said Jencks.

New Hampshire was ranked high for quality care, but Louisiana was at the bottom.

North Carolina dropped to No. 23 on the list, down from No. 18 in 1999.

Researchers claim this information is important because it points out changes that need to be made, which helps doctors and hospitals to standardize treatments and provide the best possible medical care.

The study also showed that southern states tend to score lower than other states.