In Health Care, Consumer Theory Falls Flat

[question everything]

The Wall Street Journal

CAPITAL
By DAVID WESSEL

In Health Care, Consumer Theory Falls Flat
September 7, 2006; Page A2

(snip)

An intriguing new comparison of patient-satisfaction surveys and medical records suggests one big way in which health care differs. The bottom line: Just because patients say they're very happy with their doctors and the care they're receiving doesn't mean they're getting good care, as defined by medical experts. That makes health care an anomaly. If you go to a restaurant and like the food, it doesn't matter whether the local restaurant critic agrees with you. If you think an airline offers a good price at a convenient time on a flight and treats you well, who cares what the travel Web sites say. If you like the car, the heck with the auto guidebooks. But health care?

Researchers from the Rand Corp. think tank, the University of California at Los Angeles and the federal Department of Veterans Affairs asked 236 elderly patients at two big managed-care plans, one in the Southwest and the other in the Northeast, to rate the medical care they were getting. The average score was high -- about 8.9 on a scale from zero to 10.

(snip)

Americans as patients, in at least this respect, resemble Americans as voters. They often condemn the system, but they like their own connection to it. A recent Wall Street Journal/NBC News poll found 60% of the public disapproves of Congress, but a significantly smaller 48% wanted to replace their own congressman.

In the second part of their study, the medical researchers systematically examined 13 months of medical records to gauge the quality of care the same elderly patients had received, using a comprehensive measure of quality developed by Rand's Assessing Care of Vulnerable Elders program. (An example: "If a vulnerable elder has an acute myocardial infarction or unstable angina, then he or she should be given aspirin therapy within one hour...") The average score wasn't as impressive as those in the patient-satisfaction surveys: 5.5 on a 10-point scale. But here's the interesting part: Those patients who graded the quality of their care as 10 weren't any more likely to be getting high-quality care than those who gave it a grade of 5. The most-satisfied patients didn't get better medical care than the least-satisfied.

(snip)


• For more on the Rand study, see
www.rand.org/news/press.06/05.01.html3


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