Healthy Policy: Equally Terrible

March 22, 2006

Equally Terrible

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.

March 22, 2006 in Medical Treatment | Permalink

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Healthy Policy

A journey through policy, progress, and being a patient by Kate Steadman

March 22, 2006

Equally Terrible

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