ON THE AGENDA | JULY 14TH, 2017 | ANTONIO DIEP

A Public Voice on Health Care Quality

What do people like you and me have to say about quality? What do people think make for high-quality doctors or hospitals? Do people know that doctors or that hospitals can vary in the quality of care they provide?

If today’s ongoing health care debate on Capitol Hill has taught us anything, it’s that health care is a complex and divisive issue. While that debate has focused largely on finding ways to provide Americans with health insurance, one has to wonder: What is health care without quality?

Experts measure health care quality in many ways, and the amounts of money that hospitals are paid by insurers are beginning to be based on quality. But what do people like you and me have to say about quality? What do people think make for high-quality doctors or hospitals? Do people know that doctors or that hospitals can vary in the quality of care they provide?

To answer these and other questions, Public Agenda, with support from the Robert Wood Johnson Foundation, has released new research about how patients view and experience health care quality. We specifically explored the perspectives of people in three health care situations—people recently diagnosed with type 2 diabetes, people who recently had joint replacement surgery, and women who recently gave birth.

We learned that a majority of people think that both interpersonal and clinical qualities of doctors and hospitals are important for high-quality health care. Yet people still rated certain qualities differently.

The most common interpersonal quality that people across these three groups say is very important for high-quality care is that a doctor make time for patients’ questions and concerns. But we found that people rate the importance of clinical qualities differently depending on their health needs. For instance, 83 percent of people who recently had joint replacement surgery rate the clinical qualities of doctors as very important, while only 43 percent of women who recently gave birth and 41 percent of people who were recently diagnosed with type 2 diabetes rate clinical qualities of doctors as very important. Regarding interpersonal qualities, one recent mother from our New York City focus group said her doctor “was really personable” and “available,” which was especially important to her since she was giving birth for the first time. But a woman in Florida who recently had a joint replacement said, “I think you really need to do your homework and get a doctor that really knows what he’s doing.” This suggests that people’s priorities vary depending on the type of care they need.

Although experts know that quality can vary significantly, we found that across the three groups, awareness of quality variation is limited. This was especially the case for clinical qualities, with fewer people being aware that those formally measured qualities vary across doctors or hospitals.

Any conversation about health care quality should not just focus on providing people with information to make better choices, but also on improving health care quality across the board. Low-quality care can have serious medical consequences and can be financially ruinous for patients and their families. It can be costly to employers and insurers, including Medicare and Medicaid. This makes it all the more important to know what qualities matter to people who need care, so that leaders can continue focusing on improving the quality of care for everyone.

For more insights into what qualities matter in diabetes care, joint replacement surgery and maternity care, check out our report, “Qualities that Matter.”


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