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Program Results Report

An RWJF Collection

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

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.

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