Congressional Briefing - May 8, 2006

Who Is at Greatest Risk for Receiving Poor Quality Health Care?

Presented by Dr. Elizabeth McGlynn

Monday, May 8, 2006
12:00-1:30 P.M.
2253 Rayburn House Office Building

Elizabeth McGlynn, Ph.D., Associate Director of RAND Health, and Director of the Center for Research on Quality in Health Care will present recently released analysis from the RAND Community Quality Index study – the most comprehensive assessment to date of health care quality in the United States.

The first paper in this landmark study published by RAND in 2003 in the New England Journal of Medicine documented that Americans receive just 55% of recommended care for the leading causes of death and disability. In 2004, the RAND team reported that quality did not vary much by where people live, ranging from 59% of recommended care in Seattle, Washington to 51% in Orange County, California and Little Rock, Arkansas. The most recent phase of the work examined the relationship between patient characteristics and quality of care.

The newest findings in the study, published in the New England Journal of Medicine, found that:

  • While disparities in quality exist across different groups for different conditions, these differences are dwarfed by the gap between care needed and care received for all groups;
  • Socio-demographic characteristics, including income and insurance status, make only a small difference in the likelihood of receiving recommended care; and
  • While policies and programs to reduce disparities across groups are still important as part of an overall quality improvement efforts, attacking the quality problem in the U.S. health care will also require a focus on large-scale improvements, such as system-wide investments in health information technology (HIT), performance tracking, and incentives for improvement.

Americans are spending $2 trillion annually on health care, yet all adults in the United States are at risk for receiving poor health care, no matter where they live; why, where, and from whom they seek care; or what their race, gender, or financial status is.