Doctor's Visit

Measuring Care

Tuesday, May 9, 2006

Older patients' ratings of the quality of their health care may not reflect whether their doctors gave them all appropriate tests and treatments, according to a study in the Annals of Internal Medicine. Instead, patients' assessments say more about their doctors' bedside manner, says internist John T. Chang of UCLA, who led the study. While doctor-patient communication is vital, he says, patient ratings of doctor performance are less reliable than colder-eyed assessments.

Patients' Call For the study, funded by drug maker Pfizer, Chang and his colleagues asked 236 elderly patients to rate their recent health care on a scale of zero to 10. Patients also judged if doctors and staff listened carefully, explained treatments clearly and otherwise communicated well. The researchers consulted medical records to determine how closely each patient's care matched that warranted by his or her condition. For example, elderly patients with diabetes should generally be given a daily aspirin; those who have problems with gait, strength or endurance should be offered an exercise program.

Lousy but Likable? By late next year, hospitals nationwide are expected to implement a standardized process for measuring and reporting health-care quality data. The government-designed system will make publicly available both statistics on patient welfare and patients' subjective evaluations of care. "As we move toward more transparency, [patient] evaluations may resonate more with consumers because they think they understand them," says Deirdre Mylod of Press Ganey Associates, a South Bend, Ind.-based firm that measures health-care satisfaction. But high ratings don't necessarily mean patients are getting good care, she cautions. Physician Samantha Collier, of Denver-based HealthGrades, adds, "If we were to use patient satisfaction ratings as the sole measure of quality, we could push patients toward really nice but not-so-good doctors."

-- Ben Harder

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