The American Public on Health Care-The Missing Perspective - (Page 34)

The Power of Information The American people believe that information has the power to improve the quality and efficiency of the health care system. They want to know more about both the cost of health care and the performance of their providers. They want access to better information about quality and cost, and they are willing to share their own health and medical data to improve quality and accountability throughout the system. The Need to Know: More About Performance and Cost A young man in Miami wants some way to know if he really needs the medication he is being prescribed. A woman takes the point one step further: she wants to know about CT scans and blood tests. concerns about quality of care are well-founded: a 2003 RAND Corporation study found that U.S. patients received only 54.9% of the recommended care for their health conditions10(see Figure U ). The quality of care provided by hospitals is also highly valued. Again, the public wants to know first and foremost about records of medical mistakes and adherence to clinical guidelines and standards. Information about experience with specific surgical procedures is also considered critical by a majority of Americans (see Figure V ). The public currently lacks ready access to the information it wants. The Accenture Institute for Public Service Value recently conducted a study of health practices in six countries—the United States, the United Kingdom, Australia, Germany, Canada, and New Zealand—and determined that in the United States, good information is available on access and wellness, but information on cost and on quality of care is significantly lacking. All of the countries have their strengths and weaknesses but, by a narrow margin, the United Kingdom emerges from this study as the strongest performer. Its approach to the provision of information has placed great emphasis on individual choice and the informed consumer as a means of improving health and health care; consumer information on health care coverage, cost, and quality is good. The Accenture study suggests that information for health care consumers should be locally relevant, with data on area health care providers. At the same time there must be consistency in the volume and quality of information available across the country. In the United States, this is not the case. “I want to know what exams are being sent to me because the doctor’s afraid of a future malpractice as opposed to because I really need that exam.” Americans are concerned about the performance of their health care providers. When evaluating the criticality of information about doctors in their health plan, the public prioritizes two performance measures above others: doctors’ record of medical mistakes, and whether they consistently follow standards and guidelines in diagnosing and treating patients. The public’s 10 McGlynn, Asch, Adams, et. al., “The Quality of Health Care Delivered to Adults in the United States,” New England Journal of Medicine 384:26, June 26, 2003, pp. 2641-2642. 34

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