Until recently, Maine could track the care and costs of respiratory disease, such as asthma or chronic obstructive pulmonary disease (COPD), only through hospital visits, which accounted for only a small part of a much larger story. Starting this month, however, a data-collection program begun three years ago will begin to provide understanding on these and many other illnesses, in turn making Maine the first state in the nation to answer health care questions that could barely be asked just a few years ago.

Gov. John Baldacci is expected to announce soon access to the large amount of information contained in the Maine Health Care Claims Data Bank, which began collecting data in 2001. The bank should help policy-makers, providers, insurers and, eventually, the general public better grasp improved models of care and opportunities for savings. For instance, though hospitals have been for years reporting in-patient care for asthma and COPD, emergency rooms haven’t and neither have doctors’ offices.

But under the new data-collection system, just for 2003, beneath the hundreds of hospitalizations for these diseases were thousands of emergency-room visits and tens of thousands of physician visits. With the technical assistance of the nonprofit Maine Health Information Center, the state data organization can break down those numbers to follow, at the level of individual patients, the diagnosis, procedure, medication, outcome and payment.

Lynn Davey, director of the Kids Count Data Book, which annually offers a statistical look at the health of Maine children, says the new information will allow researchers to study a variety of health issues at a deeper level than before, including, for instance, the effectiveness of preventive medical and dental care. The data bank will also bring much needed focus on an area Kids Count has discussed for a couple of years: the cost of mental-health treatment for children, which is much higher than previously assumed.

Privacy, naturally, is a major concern with this in-depth approach. James Harner of MHIC says any identifying information, including hometown, is encrypted first by the insurer before being sent to his organization, then encrypted a second time between MHIC and the state. He points out that the state has been handling this kind of information for 25 years without mishap.

Getting a better understanding of where private and public health dollars go and how the pattern changes based on the care received is crucial to making informed choices about health policy. Maine may be the first to collect this information, but it certainly won’t be the last.