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Most Get Mediocre Health Care
The above headline came from
a March 16, 2006, Associated Press story by Jeff Donn that appeared in many
newspapers and online outlets. The article was based on a study
published in the March 16th New England Journal of Medicine (NEJM) and
starts out by noting that, "Americans -- rich, poor, black, white -- get
roughly equal treatment, but it's woefully mediocre for all".
In
this study, researchers examined medical records and conducted phone
interviews with 6,712 randomly picked patients who visited a medical office
within a two-year period in 12 metropolitan areas from Boston to Miami to
Seattle. The survey questioned whether people got what researchers considered
to be the highest standard of medical treatment for 439 items measured for
both common chronic and acute conditions and disease prevention. They investigated
to see whether people got the right tests, drugs and medical
treatments.
The results of the study
showed that overall patients received only 55 percent of recommended steps
for what the researchers determined was top-quality medical care.
Interesting and contrary to what researchers expected to find, the study
results showed that Blacks and Hispanics as a group each got 58 percent of
the best care, compared to 54 percent for whites. Finances did play a
role in that households with an income over $50,000 got 57 percent, 4
points more than people from households of less than $15,000. Additionally,
patients without insurance got 54 percent of recommended steps, just one
point less than those with managed care. The study also showed that
women came out just slightly ahead of men in receiving optimum care.
Dr. Donald Berwick, who runs
the nonprofit Institute for Healthcare Improvement in Cambridge,
Massachusetts, commented, "This study shows that health care has
equal-opportunity defects." Dr. Steven Asch, at the Rand Health
research institute, in Santa Monica, California, and study chief author
agreed, "It doesn't matter who you are. It doesn't matter whether you're
rich or poor, white or black, insured or uninsured. We all get equally
mediocre care".
In the discussion the NEJM
study speaks to the problems in the way medical care is rendered, "These
results underscore the profound and systemic nature of the quality-of-care
problem." The authors of the NEJM study concluded by stating, "In this
study, we have now shown that individual characteristics that often have a
protective effect do not shield most people from deficits in the quality of
care. As the Institute of Medicine has concluded, problems with the quality
of care are indeed widespread and systemic and require a system-wide
approach." |