50/50 Chance for Proper Medical Health Care According to Study

[Guest guest]

Dear Steven,

Thank you for bringing this to my attention...

Be Well,

Misty L. Trepke

http://www..com

 

http://www.usatoday.com/news/health/2003-06-25-medical-quality_x.htm

50/50 chance of proper health care

By Rita Rubin, USA TODAY

 

On average, doctors provide appropriate health care only about half

the time, a landmark study of adults in 12 U.S. metropolitan areas

suggests.

 

Such deficiencies " pose serious threats to the health of the

American public " that lead to tens of thousands of preventable

deaths each year, researchers report in today's New England Journal

of Medicine.

 

The authors say their work is the largest and most comprehensive

examination of the quality of health care in the USA. Though the

study stopped short of linking inappropriate care to the poor health

or death of individual patients, it shows that Americans cannot take

for granted that they're getting good care, says lead author

Elizabeth McGlynn, associate director of RAND Health.

 

The study involved 7,528 adults who participated in a telephone

interview about their health history and provided access to their

medical records.

 

Researchers used the medical records to assess care for 30 common

conditions as well as preventive care. They based their evaluation

on 439 indicators of quality gleaned from established national

guidelines and medical literature. For example, if patients had high

blood pressure, researchers checked whether their doctors had

changed their medication to better control blood pressure. For

preventive care, researchers examined factors such as cancer

screening and flu shots for the elderly.

 

Overall, patients' medical charts showed that doctors provided 55%

of appropriate care. On average, that proportion varied little among

the chronic, acute or preventive care categories. McGlynn

acknowledges that it's possible that doctors didn't write everything

down in patients' charts. But that in itself represents poor-quality

care, she says. " How can they proactively follow up on something if

they don't have a note on the chart? "

 

The key to improving health care quality would be to provide

performance data on all U.S. doctors, McGlynn says. Such a step

would require " a major overhaul of our current health information

systems, " she and her colleagues write.

 

Carolyn Clancy, director of the Agency for Health Quality and

Research, says Health and Human Services Secretary Tommy Thompson is

eager to switch to a more efficient paperless health care system.

 

In an accompanying editorial, Earl Steinberg writes that

it's " ludicrous " to expect physicians to keep up with hundreds of

practice guidelines without a computerized system. " I reliably

receive reminders when my dog needs a vaccination, " writes

Steinberg, of Johns Hopkins University. " Physicians and patients

should also receive computer-driven reminders. "

 

Karen Ignagni, president of the American Association of Health

Plans, commended the study in a statement: " We couldn't agree more

that consumers in America's health care system face a dangerous

disconnect between what the best medical science recommends and the

treatment they often receive. "

 

Note - the following was in the paper but not posted on the web page!

 

Hit-and-miss health care

The study on medical care found that:

 

Patients with high blood pressure received 65% of recommended care.

Poor blood pressure control contributes to more than 68,000

preventable deaths annually, researchers say.

 

Only 45% of heart attack patients received beta-blockers, which have

been proven to reduce the risk of dying by 23%.

 

A third of patients had been screened for colorectal cancer. Routine

screening and follow-up care could prevent about 9,600 deaths each

year.