Which factors cause poor-quality care in the modern health care systems?

According to the studies, patients in the modern health care systems receive recommended care in about 50%. Traditionally, socioeconomic and demographic factors are held responsible for the deficit (financial, racial, insurance factors).

A new study where telephone interviews and medical record data were analyzed (439 aggregated quality indicators, 30 chronic and acute disease states), the deficit of care at 55% was confirmed. Statistically significant differences were found for the traditional factors (women, older patients of age over 64, and higher income patients receive medical care more often). However, these differences (max. 4%) were very small in comparison with the overall deficit. In contrast, as authors demonstrated on the data from Veterans Affairs health care system, factors like introduction of electronic patient documentation, automated ordering systems, decision-support tools and financial products can improve utilization up to 67%.

Source: New England Journal of Medicine Mar 2006; 354:1147-1156

HMC commentary: The quality attainable in the modern health care is no doubt significantly influenced by socioeconomic a demographic factors. Nevertheless, this report documents that the level and quality of care can be more substantially improved by effective methods and products to improve communication and appropriate financial products that bring effective processes and functioning of the systems.