NCPA - National Center for Policy Analysis

Rand Study: Patients in 12 Urban Areas Receive Substandard Care

May 5, 2004

Patients in the United States are receiving substandard health care about half of the time, according to a recent RAND study in the journal Health Affairs. The researchers define substandard care as lack of preventive care or wrong or unnecessary care, including tests.

The study was based on medical records of almost 7,000 people in 12 metropolitan areas. Researchers concluded:

  • Based upon treatment of 30 of the top chronic and acute conditions, patients received substandard care about 50 to 60 percent of the time.
  • Care for high blood pressure was ranked among the best, while care for diabetes ranked among the lowest.
  • Researchers also discovered that the causes were most likely to be inadequate record keeping, cultural bias toward expensive technology, and a system that rewards intervention instead of prevention.

Some states are already taking steps to provide improved health care. Medical groups and hospitals in Minnesota, for example, are developing standard practice guidelines which will apply to all of the state's public health plans. In New York, increased monitoring and public reporting of deaths resulting from heart bypass surgery has helped to decrease death rates from the procedure.

Source: Lawrence K. Altman, "Study Finds Widespread Problem of Inadequate Health Care," New York Times, May 5, 2004. Ceci Connolly, "U.S. Patients Spend More But Don't Get More, Study Finds," Washington Post, May 5, 2004. Eva A. Kerr, Elizabeth McGlynn, et al. "Profiling the Quality of Care in Twelve Communities: Results from the CQI Study," Health Affairs, May/June 2004.

For NYT article

For RAND study (subscription required)


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