A new study published in JAMA Internal Medicine examines the quality of outpatient care for adults in the United States.
The study authors gathered data from 2002 to 2013 and analyzed the Medical Expenditure Panel Survey quality measures for clinicians, hospitals, pharmacies and employers. There were 20,678 to 26,509 individual participants per year.
The researchers found:
1. Over the study period, the clinical quality composites that improved were:
• Recommended medical treatment: 36 percent to 42 percent
• Recommended counseling: 43 percent to 50 percent
• Recommended cancer screening: 73 percent to 75 percent
• Avoidance of inappropriate cancer screening: 47 percent to 51 percent
2. The two clinical composites that worsened were the avoidance of appropriate medical treatment — dropping from 92 percent to 89 percent — and avoidance of inappropriate antibiotic use — dropping from 50 percent to 44 percent.
3. The three unchanged measures were:
• Recommended diagnostic and preventative testing: 76 percent
• Recommended diabetes care: 68 percent
• Inappropriate imaging avoidance: 90 percent
4. There were a few categories where more participants highly rated their care as time went on. The number of participants who highly rated their overall care went from 72 percent to 77 percent; physician communication jumped from 55 percent to 63 percent; and access to care was up to 58 percent from 48 percent when the survey began.
5. When analyzing the data, the study authors concluded the quality of outpatient care did not improve consistently. "Patient experience has improved," the study authors concluded. "Deficits in care continue to pose serious hazards to the health of the American public."
