Mediocre health care: Fact or truth?

Here’s another study that any patient could tell you the truth of. Health
care in the US is mediocre at best. What a new flash. It’s hard to know if
it’s comforting or not to know ethnicity, income and any of the other
categories they love to use to slice us in to are equally treated like crap.
Now lets see a survey as to the level of health care received by members of
congress compared to the public as a whole. That’s another $2,000,000 study
we all already know the answer to.
Thanks for paying the price of my editorial to get to the article–og

Study: Most Get Mediocre Health Care
By JEFF DONN, Associated Press WriterThu Mar 16, 9:48 AM ET

Startling research from the biggest study ever of U.S. health care quality
suggests that Americans – rich, poor, black, white – get roughly equal
treatment, but it’s woefully mediocre for all.

“This study shows that health care has equal-opportunity defects,” said Dr.
Donald Berwick, who runs the nonprofit Institute for Healthcare Improvement
in Cambridge, Mass.

The survey of nearly 7,000 patients, reported Thursday in the New England
Journal of Medicine, considered only urban-area dwellers who sought
treatment, but it still challenged some stereotypes: These blacks and
Hispanics actually got slightly better medical treatment than whites.

While the researchers acknowledged separate evidence that minorities fare
worse in some areas of expensive care and suffer more from some conditions
than whites, their study found that once in treatment, minorities’ overall
care appears similar to that of whites.

“It doesn’t matter who you are. It doesn’t matter whether you’re rich or
poor, white or black, insured or uninsured,” said chief author Dr. Steven
Asch, at the Rand Health research institute, in Santa Monica, Calif. “We all
get equally mediocre care.”

The researchers, who included U.S. Veterans Affairs personnel, first
published their findings for the general population in June 2003. They
reported the breakdown by racial, income, and other social groups on

They examined medical records and phone interviews from 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 group was not
nationally representative but does convey a broad picture of the country’s
health care practices.

The survey examined whether people got the highest standard of treatment for
439 measures ranging across common chronic and acute conditions and disease
prevention. It looked at whether they got the right tests, drugs and

Overall, patients received only 55 percent of recommended steps for
top-quality care – and no group did much better or worse than that.

Blacks and Hispanics as a group each got 58 percent of the best care,
compared to 54 percent for whites. Those with annual household income over
$50,000 got 57 percent, 4 points more than people from households of less
than $15,000. Patients without insurance got 54 percent of recommended
steps, just one point less than those with managed care.

As to gender, women came out slightly ahead with 57 percent, compared to 52
percent for men. Young adults did slightly better than the elderly.

There were narrow snapshots of inequality: An insured white woman, for
example, got 57 percent of the best standard of care, while an uninsured
black man got just 51 percent.

“Though we are improving, disparities in health care still exist,” said Dr.
Garth Graham, director of the U.S. Office of Minority Health.

Graham, who is black, pointed to other data showing enduring inequality in
care, including a large federal study last year. He also said minorities go
without treatment more often than whites, and such people are missed
entirely by this survey.

Some experts took heart in the relative equality within the survey. “The
study did find some reassuring things,” said Dr. Tim Carey, who runs a
health service research center at the University of North Carolina-Chapel

But all health experts interviewed fretted about the uniformly low standard.
“Regardless of who you are or what group you’re in, there is a significant
gap between the care you deserve and the care you receive,” said Dr. Reed
Tuckson, who is black and a vice president of United HealthGroup, which runs
health plans and sells medical data.

Health experts blame the overall poor care on an overburdened, fragmented
system that fails to keep close track of patients with an increasing number
of multiple conditions.

Quality specialists said improvements can come with more public reporting of
performance, more uniform training, more computerized checks and more
coordination by patients themselves.