Perceived Health Care Quality Varies Substantially by Facility

Nearly 80 percent of Americans reflect positively on the health care they personally receive, but only a third (33%) says their care is excellent, while 46 percent rate it as good. When added to the 18 percent of adults in the United States who say their care is fair or poor, the data suggest the United States has a long way to go if it hopes to have one of the highest-quality health care systems in the world.

The poll asked American adults who had used doctor’s offices, hospitals, emergency rooms, urgent care centers and retail or drug store mini-clinics at least once in the past two years to rate their experiences as either excellent, good, fair or poor. Doctor’s offices received the highest ratings, with 43 percent of patients saying the quality of their last visit was excellent, while one in eight (13%) say it was fair or poor. On the other hand, emergency rooms received the lowest ratings, with more than one in four (27%) recent patients saying the quality of their care was fair or poor.

When asked to rate six aspects of their most recent visit to a doctor, patients nationwide were most dissatisfied with their ability to get in touch with the doctor outside of an appointment by phone or email—29 percent saying it fair or poor. They were most satisfied with the doctor’s sensitivity to their cultural background—with 11 percent saying fair or poor.

Six in Ten Consider Health Care Costs Reasonable, But Many Americans Still Struggle

Sixty percent of Americans say the overall cost they personally pay for their health care, including premiums, deductibles, co-payments and prescription drugs, is reasonable; however, nearly three in ten (29%) adults in the United States disagree, saying the cost they personally pay for their care is unreasonable. More than a third (34%) of Americans also believes the cost of health care services has become less affordable in the past two years, and more than one in five (22%) say the same of prescription drugs.

For many Americans, rising health care costs have major financial consequences. More than one in four (26%) adults in the United States say health care costs have caused serious financial problems for them or their family in the past two years. Among those who say they have experienced serious problems, more than 40 percent say they have spent all or most of their personal savings on large medical bills.

“It is clear from the poll that health care costs should top the agenda for what needs to be done in the future—especially in some states, where more than a third of people have serious problems paying their bills,” said Robert J. Blendon, Richard L. Menschel Professor of Health Policy and Political Analysis at Harvard T.H. Chan School of Public Health.

Majority of Americans Say Health Benefits Remain the Same, But Significant Numbers Say Costs Have Increased

Seventy percent of Americans with health insurance say their benefits have stayed about the same over the past two years, whereas 45 percent say their premiums have increased, and 35 percent say their co-pays and deductibles have increased. Among those who believe their benefits have changed, about the same proportion believes their benefits have decreased as increased. Overall, even though most (73%) Americans say their health insurance coverage is excellent or good, one in four (25%) adults in the United States says their coverage is either fair or poor.

This poll is part of an ongoing series of surveys developed by researchers at the Harvard Opinion Research Program (HORP) at Harvard T.H. Chan School of Public Health in partnership with the Robert Wood Johnson Foundation and NPR. The research team consists of the following members at each institution.

Harvard T.H. Chan School of Public Health: Robert J. Blendon, Richard L. Menschel professor of health policy and political analysis and executive director of HORP; John M. Benson, research scientist and managing director of HORP; Caitlin L. McMurtry, research assistant; and Justin M. Sayde, administrative and research manager.

Robert Wood Johnson Foundation: Fred Mann, vice president, Communications; Carolyn Miller, senior program officer, Research-Evaluation-Learning; and Joe Costello, director, Marketing.

NPR: Anne Gudenkauf, senior supervising editor, Science Desk; and Joe Neel, deputy senior supervising editor, Science Desk.

The “Patients’ Perspectives on Health Care in the United States” project consisted of eight polls, conducted via telephone (including both landline and cell phone) by SSRS of Media (PA). Interviews were conducted in English and Spanish, using random-digit dialing, September 8—November 9, 2015, among representative samples of adults age 18 or older nationally and in the seven states.

For the national poll, interviews were conducted with a nationally representative probability sample of 1,002 U.S. adults. The margin of error for total U.S. respondents is ± 3.8 percentage points at the 95% confidence level. For the state polls, sample sizes and margins of error are included in the table below.

Possible sources of non-sampling error include non-response bias, as well as question wording and ordering effects. Non-response in telephone surveys produces some known biases in survey-derived estimates because participation tends to vary for different subgroups of the population. To compensate for these known biases and for variations in probability of selection within and across households, sample data are weighted by household size, cell phone/landline use, and demographics (sex, age, race/ethnicity, education, marital status, and census region) to reflect the true population. Other techniques, including random-digit dialing, replicate subsamples, and systematic respondent selection within households, are used to ensure that the sample is representative.

ABOUT HARVARD T.H. CHAN SCHOOL OF PUBLIC HEALTH

Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people’s lives—not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health.

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NPR is the leading provider of non-commercial news and entertainment programming in the United States. More than 27 million people listen to NPR programs each week via 800+ radio stations throughout the country. In partnership with Member Stations, NPR strives to create a more informed public—one challenged and invigorated by a deeper understanding and appreciation of events, ideas, and cultures. As a digital innovator, and a leader in the public media community, NPR assures that the unique mission of nonprofit public media is not only preserved, but grows.

ABOUT THE ROBERT WOOD JOHNSON FOUNDATION

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are working with others to build a national Culture of Health enabling everyone in America to live longer, healthier lives. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.