U.S. Residents Often Do Not Receive Recommended Care, Study Finds
People in the United States receive appropriate treatments and preventive care only about half of the time, regardless of where they live, according to a study in the May/June issue of Health Affairs, the New York Times reports. The report was financed by the Robert Wood Johnson Foundation and led by Eve Kerr, a research scientist at the Ann Arbor Veterans Affairs Center for Practice Management and Outcomes Research and an assistant professor at the University of Michigan, and Elizabeth McGlynn, an associate director at RAND Health. In the "first comprehensive study of health care provided in metropolitan areas," researchers examined interviews and medical records from 6,700 people between 1996 and 2000 in 12 metropolitan areas -- Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; Newark, N.J.; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y., the Times reports (Altman, New York Times, 5/5). Researchers analyzed whether patients received recommended treatments for 30 conditions -- including high blood pressure, asthma, breast cancer and depression -- as well as preventive treatments, such as cancer screening and vaccinations. They found that in all geographic areas studied, patients received only about 50% to 60% of recommended treatments. For example, fewer than 66% of elderly patients received pneumonia vaccinations, and many people with diabetes did not have their blood sugar measured. Even in Seattle, which received the highest overall score, patients received recommended treatments only about 59% of the time (Appleby, USA Today, 5/5).
"No matter where you live, you are at risk of poor care, even if you live in communities with the best teaching hospitals in the country," Kerr said (Stewart, Newark Star-Ledger, 5/5). Researchers concluded that the poor statistics "could be improved with widespread adoption of electronic medical records" and other computerized systems, according to USA Today. Improved use of technology in medical care could save money by reducing waste, McGlynn said (USA Today, 5/5). She added, "We could do a whole lot better with the same dollars if we made sure tests were not repeated or patients didn't get antibiotics when they didn't need them" (Connolly, Washington Post, 5/5). Researchers also recommended "pay-for-performance" contracts, through which insurers would pay higher rates to providers who provide superior medical care (Kowalczyk, Boston Globe, 5/5). They also urged local communities to begin collecting quality information themselves to develop solutions tailored to their specific needs (Penner, Indianapolis Star, 5/5). In addition, researchers recommended that research agencies conduct further studies to assess quality of care in additional metropolitan areas. Dr. Donald Palmisano, president of the American Medical Association, said that "there is room for improvement" in medical care, adding, "The main challenge is quick retrieval of pertinent information" (New York Times, 5/5). However, Dr. Thomas Lee, network president for Partners HealthCare, the parent organization of Massachusetts General and Brigham and Women's Hospitals, said the report includes "a long list of things that are recommended, but they're not all equally important. The things that are more important are done more often. So the results look worse than the reality" (Boston Globe, 5/5). The report is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.