The First National Snapshot of Health Care Quality in the United States

Study to examine variations in the quality of care

Field of Work: Measuring quality of health care

Problem Synopsis: Numerous studies had documented serious deficits in the quality of health care in the United States. But most of these studies focused on a single condition, a small number of indicators of quality, persons with a single type of insurance coverage, or persons receiving care in a small geographic area. As a result, there was no comprehensive view of the level of quality of care given to the average person in the United States. This information gap contributed to a persistent belief that quality was not a serious national problem.

Synopsis of the Work: From 1997 to 2002, researchers with the RAND Corporation assessed the quality of care delivered to a large sample of patients living in 12 U.S. communities. The resulting publications provided the first national snapshot of health care quality in the United States.

Key Findings: Publications in health care journals such as the New England Journal of Medicine, the Annals of Internal Medicine, and Health Affairs presented the findings:

  • Overall, adults received 55 percent of recommended care for the leading causes of death and disability and the major reasons adults use the health care system.
  • Overall, children received just 47 percent of recommended care for 12 clinical areas and preventive care.
  • Quality of care was similar across the 12 major metropolitan areas studied, ranging from 51 percent to 59 percent of recommended care.
  • Everyone is at risk for receiving poor quality care. Remarkably little variation was found by age, gender, race, income, education, and insurance status.