Health care quality issues: The disconnect between patients and experts

Jun 5 2010

The Kansas City Star: Improving "health literacy" could help improve patient outcomes and quality. This literacy is "the limited ability to understand the technical jargon, the orders, the prescriptions and the forms coming from doctors, nurses, pharmacists and insurance companies. This failure to communicate leads to missed doctor appointments, medications taken incorrectly, instructions ignored — all contributing to worsening health." In Missouri, a group estimates that 1.6 million adults have trouble understanding health instructions which could cost the state up to $7.5 billion annually. "Health information often assumes a 12th-grade or higher reading level. Only half of American adults read above a fifth-grade level. … Missouri Health Literacy is using multiple approaches in different parts of the state" (Bavley, 6/3).

Another quality concern is the "July Effect" — concerns that when residents - fresh out of medical school - begin, they are prone to mistakes. The Wall Street Journal Health Blog reports that a study "published last year concluded the myth didn't hold true at one trauma center, and American Medical News also noted that July seems to be a pretty safe month for surgery. But when researchers from the University of California at San Diego and UCLA set out to investigate the phenomenon, they homed in on fatal medication errors inside medical institutions, assuming those are 'more likely to be influenced by inexperienced residents than by patients.' .... they report a 'significant July spike' in those errors in counties that include teaching hospitals. Mortality from medication errors was 10% above the expected level, they write" (Hobson, 6/3).

NPR Shots Blog: "When experts talk about cost effective medical care, patients don't listen. ... The journal Health Affairs just surveyed more than 1,500 patients with employer-provided insurance ... The 'pervasive themes' from respondents, according to the authors, were 'more is better, newer is better, you get what you pay for, (and) guidelines limit my doctor's ability to provide me with the care I need and deserve.' Such findings are frustrating for experts who have spent years trying to communicate that those things are not true (Rovner, 6/3).