Failure to Provide “Right Care” Documented by Study

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EVEN AS THE HOUSE–SENATE CONFERENCE COMMITTEE determines the fate of the 20% co-payment for laboratory tests, our lead story in this issue of THE DARK REPORT looks at the impact of a remarkable study on the quality of healthcare delivered to the average American patient just published in the New England Journal of Medicine (NEJM). (See this article.)

The findings probably don’t surprise most of us in laboratory medicine. In a study of 13,000 people, researchers determined that patients fail to get recommended care 45% of the time! That means almost half of all healthcare consumers are not getting the standard of care recognized as appropriate! It was also determined that 11% of patients receive care which is either not recommended for their condition or potentially harmful.

As strategic intelligence of greatest importance, our assessment is that the findings of this RAND Health study will have greater impact upon laboratory medicine than the eventual outcome of the current efforts in Congress to reimpose the 20% co-pay. That’s why the briefing about the study on patient care quality leads off this issue.

As you will read, RAND Health researchers did a thorough job of interviewing individuals over the phone, obtaining consent to access their medical records, then evaluating those medical records. Using rigorous methodology, they determined that healthcare providers were giving patients the care recommended for their particular condition only 54.9% of the time!

Our clients and regular readers will understand the ramifications of these findings. Both employers and consumer advocacy groups will use them to justify greater scrutiny of provider quality. It certainly weakens arguments by hospitals and physicians that overall levels of care are acceptable—and the real issue is eliminating medical errors. The findings of this study directly contradict that position.

Moreover, this finding is remarkable for a study that only cost $6.5 million, which is chump change in the world of healthcare consulting and research. I recommend that pathologists and laboratory executives read the NEJM article in full, and include this element in their laboratory’s strategic planning.


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