When defining quality, it is important to understand that patients value different qualities of care depending on their health needs, according to a new survey from Public Agenda, supported by the Robert Wood Johnson Foundation.
According to a newly-released report based on findings from three national surveys of people recently diagnosed with type 2 diabetes, people who recently had joint replacement surgery and women who recently gave birth, most people do not think quality and price are related.
Questions were asked about their perspectives on interpersonal qualities of doctors, such as how doctors communicate with patients, and about their perspectives on clinical qualities of doctors and hospitals, such as rates of patients’ health outcomes. Findings are based on three nationally representative surveys: one survey of 407 adults (ages 18 years and older) diagnosed with type 2 diabetes between July 2013 and October 2016; one survey of 406 adults (ages 18 years and older) who had joint replacement surgery between July 2013 and October 2016; and one survey of 413 women ages 18 to 44 who gave birth at a hospital between July 2013 and October 2016. For all three surveys, the samples were weighted to correct for variance in the likelihood of selection for a given case and to balance the sample to known population parameters to correct for systematic under- or overrepresentation of meaningful social categories.
“Most also say that they did not spend more out of pocket to get the quality of care they wanted,” says David Schleifer, director of research, Public Agenda.
More specifically, the survey found across all three groups:
• A majority of people say both interpersonal and clinical qualities of doctors and hospitals are important for high-quality care. But how important depends on their health needs.
• Few people across the three groups are aware that quality varies or that price varies for doctors or for hospitals.
• Most people said they had at least some choice among doctors. But fewer people who recently had a joint replacement or gave birth had much choice among hospitals.
• Most people rate the overall quality of care they received positively. But some are uncertain how their doctors and hospitals stacked up on clinical qualities.
• More people spent time learning about the care they needed than about doctors or hospitals providing that care. Few people knew or tried to find out if a doctor or hospital had the clinical qualities that they think are important.
• About half of people say there is enough information available about quality. Fewer say there is enough information about price.
“Patients care about both interpersonal and clinical qualities, and to truly have patient-centered care, providers, insurance companies and other payers, as well as regulators and other leaders need to keep this in mind,” Schleifer says “More work needs to be done to measure and communicate about these qualities in ways that are relevant to people seeking care based on their specific situation.”