Industry experts are hoping a new report showing Americans are highly unsatisfied with the countrys healthcare may finally spur stakeholders to ramp up quality improvement, with the report suggesting ways to do so.
The report, centered on a survey of American consumers sponsored by and conducted for the Commonwealth Funds Commission on a High Performance Health System, indicates that 82% of American adults want the system changed to better suit their needs. Those respondents said that fundamental changes are needed to fix recurring problems of poor quality and an increasingly outdated delivery system, according to the survey by Harris Interactive.
The report, called Organizing the U.S. Health Care Delivery System for High Performance, came the same week that the Centers for Disease Control and Prevention released data showing record use of medical services.
Whats shocking in this study is the high proportion of people who indicate that the system is not working for them, said Commonwealth Fund President Karen Davis. The high number of patients calling for change, she added, would be akin to a vote of no confidence in any other industry.
To curtail the dissatisfaction, the Commonwealth Fund calls for a multipronged approach to fixing the healthcare delivery model: moving from traditional fee-for-service payments to a system where providers are paid for high-quality, patient-centered care; incentives for patients who seek out such providers; regulatory changes to rules that muzzle providers from sharing patient data; and the widespread use of electronic health records. Many of the same recommendations have been suggested before, but have either been shelved or failed to gain enough momentum.
Carmela Coyle, president and chief executive officer of the Maryland Hospital Association, said hospitals have been working for years to improve care coordination, but often are frustrated by federal laws and regulations that impede change. For instance, many hospitals have adopted health information technology components, such as EHRs, she said. But in the end, if we dont ultimately get the standards at the national level, its just going to slow the pace, she said.
But the industrys complacency could change as more providers become increasingly aware of the patient-safety and quality problems inherent in the disjointed healthcare system, said James Mongan, CEO of Partners HealthCare System, Boston, and chairman of the Commission on a High Performance Health System.
In its report, the Commonwealth Fund found that fragmentation in todays delivery system is the main culprit behind the generally shoddy quality of care thats being delivered nationwideeverything from miscommunication between doctors and patients all the way to otherwise preventable medical errors.
While the survey results arent an out-and-out condemnation63% held a generally favorable view of their healthcare experience, for instancethey nevertheless point to a number of areas in need of improvement.
Thirty percent of respondents, for instance, said they had trouble getting a doctors appointment within 24 hours, and 50% found it difficult to get care on nights, weekends or holidays. Eighteen percent said they had experienced medical errors.
The May phone survey used a representative sample of 1,004 respondents 18 and older, who also said that they wanted a more cohesive healthcare system, with nine of 10 saying that its important to have one place or doctor responsible for their primary-care coordination.
The survey follows data released separately by the CDC showing record use of medical services. According to the CDC, U.S. patients made an estimated 1.1 billion visits to doctors offices and hospitals in 2006, an increase of 26% from 1996 and an average of four visits per person per year. Also, many more of those visits are coming through the emergency department.