Do Patients Receive About Half of Recommended Health Care?

David McKalip, M.D.

6/10/2009

The idea that patients receive about half of recommended care when they see physicians is the conclusion of a RAND Corporation study [gated, but with abstract], spearheaded by Elizabeth McGlynn and colleagues. In fact, not a single outcome of care (like death, infection, ability to walk, relief of pain, return to work) was analyzed. Instead, the study focused only on 439 inputs called “indicators.” These inputs range from the serious and uncontroversial (giving a heart exam to patients with chest pain) to the unobjectionable but possibly trivial (counseling smokers to stop smoking, alcohol abusers to reduce their drinking, and patients with sexually transmitted diseases to practice safe sex).

Four questions immediately jump to mind: (1) What does it mean to say that a procedure is “recommended care?” (2) How do we know that the recommended care is actually good for patients? (3) How do we know whether the patients actually got the care? and (4) Does it make sense to combine the serious with the trivial in making a judgment about the overall quality of the US health care system?

The story continues …..