Americans don't get recommended care

September 1, 2003

Pharmaceutical Representative

Adults in the United States fail to receive recommended healthcare nearly half the time, according to a new study published in The New England Journal of Medicine.

Adults in the United States fail to receive recommended healthcare nearly half the time, according to a new study published in The New England Journal of Medicine (vol. 348, no. 26). Researchers found that these deficiencies in care pose "serious threats to the health of the American public" that could contribute to thousands of preventable deaths in the United States each year.

Nearly 7,000 adults in 12 metropolitan areas were interviewed by telephone about selected healthcare experiences. In addition, those interviewed gave written consent for researchers to review their medical records and use the information to evaluate performance on 439 detailed clinical indicators of care for 30 acute and chronic conditions, as well as preventive care.

Varying levels of care

Quality (in terms of the percentage of patients who received recommended care) varied substantially according to medical condition, ranging from 79% of recommended care for cataracts among older people to 11% of recommended care for people with alcohol dependence. The study also found that:


•Â People with diabetes received only 45% of the care they needed. For example, less than one-quarter of diabetics had their blood sugar levels measured regularly.


•Â People with coronary artery disease received 68% of recommended care, but just 45% of heart attack patients received medications that could reduce their risk of death by more than 20%.


•Â Patients with pneumonia received just 39% of recommended care, and less than two-thirds of elderly Americans were vaccinated against pneumonia.


•Â Patients with colorectal cancer received 54% of recommended care, but just 38% of adults were screened for colorectal cancer.

"Even people who had health insurance and access to healthcare services failed to receive some elements of good care," said Elizabeth McGlynn, a collaborator on the study. "This suggests that just being able to get in the door to see a doctor is no guarantee that you'll receive the care you need." PR

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