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Consumer-Driven Healthcare: Customer Satisfaction Does Not Equal Quality
Consumer-driven healthcare (CDHC) is a concept that has steadily gained traction over the past decade or so.  At its heart is the idea that if patients have enough information they will make better decisions about their care.  In addition, some proponents of CDHC have suggested that people will soon start treating healthcare like other goods and services.  This means they will make decisions based on cost and quality measures, which is what people do when they are purchasing a car or flat screen television.   

However, an interesting study published in May by RAND suggests that there are major differences between healthcare and other areas of the economy.  For example if customers rate a restaurant or airline highly, you can be pretty sure that the quality of service is going to be excellent.  Not so with healthcare.  The RAND study indicates that even if people say they are satisfied with their care, they are not getting high-quality treatment. In short, a high customer satisfaction score does not translate into better outcomes. Managed care companies and hospitals conduct patient satisfaction surveys all of the time because they are easy to produce.  However, some of these studies suffer from non-responder bias.  This means that people who are satisfied with their care tend to respond to the survey.  Those who are dissatisfied will no longer use the plan or visit the hospital – making them ineligible for the study.  

If Not Customer Satisfaction, What Should We Measure?

In an article that appeared late last week, Wall Street Journal columnist David Wessel used the RAND study to suggest that the “consumer theory falls flat” when it comes to healthcare.  I disagree with this assessment, partly because the RAND survey indicates to me that people need better and more objective measures of quality to accurately rate physicians, managed care companies, hospitals and other players in the healthcare system. 

For example, when rating a provider or hospital, people should receive information like: 

- How many procedures they have conducted (e.g., open heart surgery) and the outcomes experienced by patients (i.e., deaths, complications due to surgery, etc.)

- The number of people infected by hospital-based bacteria (this can lead to poorer outcomes)

- The patient to doctor ratio at the hospital – i.e., how many patients each doctor sees per day and how much time they spend with them.  This is important because a physician that spends more time with patients will be better able to diagnose difficult-to-treat conditions like depression.

When it comes to communicating about healthcare in world where patients are being asked to take more responsibility for their medical care, people need the right kind of information.  As healthcare communicators, we should focus on giving people what they need to make sound decisions about their medical care.  Tracking and reporting meaningful measures of quality is one way to do this.

For More On CDHC, please see these posts from Envisioning 2.0

- Consumer-Driven Healthcare Series

- Pricing Transparency: An Interesting Idea, But . . .

1 Comments/Trackbacks

I agree with the idea that what we need to develop is effective and objective criteria that will allow us to 'rate' health care. Effective health care is not just about being nice to patients(although thats not a bad thing!), It is about increasing the percentage of positive outcomes and being proactive and preventing health problems.

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