I've been meaning to post on this for awhile, but hadn't really figured out the direction to take. A new research project by RAND found that regardless of race, age, or income, patients in the U.S. receive equal care once they get to the doctors office.
But, about that care. It's pretty bad. In fact, according to the study, patients receive the correct care about 55% of the time. The glaring comparison that enters my brain is school (a year ago at this time I was in college, taking exams and such). If I'd done 55% of my work on average, I never would have made out with my degree.
But there are some major limitations to this study. It doesn't investigate the effect of a 55% appropriate care level on patient outcomes. So we don't know if the care grade should be an F or an automatic expulsion.
Further, and this is key, the study only examined what happens once patients make it to the doctor:
Certainly some people have better access to healthcare than others, and previous studies have shown that people without health insurance get sicker and die younger than those with insurance. But this study wasn't about access to care. It was about what happens after people reach a hospital or doctor's office.
Once they're in the door, regardless of how long it took to get there, they get what they need about half the time, regardless of who they are or even whether or how they're insured, the study found. Recommended care included things that have been scientifically shown to be medically effective and are accepted as the best standard for various conditions. The researchers looked at 439 such measures of quality for 30 common medical conditions and preventive care.
That throws a wrench in things, and explains the multitude of studies showing racial and income health disparities. Patients need to get into treatment on a regular basis, and use those incomes, to have a true comparison.
The good? Patients are given equal treatment and this study found no evidence of bias based on population characteristics. Considering things like residual (and actual) racism, xenophobia, etc, it's quite impressive that our medical system treats everyone the same. That's truly something to be proud of.
Now if we could just get them to treat everyone the same, but more accurately, we'd be golden.
I love this, but I am pissed. Everyone is posting this story as if it is a revelation of how terrible health care is in the US.
IT DOES NOTHING OF THE SORTS!!
How about the possiblity that it could be an "A" or an "A+", or that the 45% have better outcomes than the 55%?
Every human being is different, and we will all react to treatment differently. And trust me I do know this for a fact. What might work for some people, will not necessarily work for someone else with the same affliction, nor might it even be appropriate.
That is why we value doctors so highly in this country. It is their experience and knowledge that we depend on to determine the best course of action.
I don't want the standard or recommended treatment, I want the treatment that is going to cure me. And that is the only information I care about.
Who gives a DAMN about what someone, who knows nothing about me or my affliction, says I may need.
When the information of patient outcomes is available, then I will take notice, but even then, I will question the data. Because we are all different, and present in different stages of disease progression, there is no conceivable way to quantify how far along a persons disease has progressed, nor what effect that may have on the eventual outcome.
Posted by: Marc | March 22, 2006 at 10:00 PM
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Posted by: master2 | October 06, 2006 at 10:02 PM