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Most Get Mediocre Health Care

The above mentined headline originate from a March 16, 2006, Associated Press story by Jeff Donn that appeared in numerous newspapers and online outlets. This article was based on a report published in the March 16th New England Journal of Medicine (NEJM) and begins by noting that, "Americans -- rich, poor, black, white -- get roughly equal treatment, but it's woefully mediocre for all".

In this study, researchers examined medical records and conducted phone interviews with 6,712 randomly picked patients who visited a medical office in a two-year period in 12 metropolitan areas from Boston to Miami to Seattle. The survey questioned whether people got what researchers thought to be the highest standard of medical treatment for 439 items measured for both common chronic and acute conditions and disease prevention. They investigated to find out whether people got the proper tests, drugs and medical treatments.

Final results of the study indicated that overall patients received only 55 percent of recommended steps for what the study determined was top-quality medical care. Intriguing and despite what researchers anticipated to find, the study results indicated that Blacks and Hispanics as a group each got 58 percent of the finest care, when compared to 54 percent for whites. Finances did play a role in that households having an income over $50,000 got 57 percent, 4 points more than people from households of below $15,000. Additionally, patients without insurance got 54 percent of recommended steps, just one point less than individuals with managed care. The study also indicated that women came out just slightly ahead of men in receiving optimum care.

Dr. Donald Berwick, who runs the nonprofit Institute for Healthcare Improvement in Cambridge, Massachusetts, commented, "This study demonstrates that health care has equal-opportunity defects." Dr. Steven Asch, at the Rand Health research institute, in Santa Monica, California, and study chief author agreed, "It does not matter who you are. It does not matter whether you're rich or poor, black or white, insured or uninsured. Everyone get equally mediocre care".

In the discussion the NEJM study speaks to the problems in the way medical care is rendered, "These results underscore the profound and systemic nature of the quality-of-care problem." The authors of the NEJM study concluded by stating, "In this study, we now have shown that individual characteristics that usually have a protective effect do not shield most people from deficits in the quality of care. As the Institute of Medicine has concluded, problems with the quality of care are indeed widespread and systemic and require a system-wide approach."

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