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Consumers Use Error Rates to Judge Health Care Quality, Survey Shows

Nancy Tarleton Landis

In a national survey of how consumers make decisions about health care, some 70% said reports of medical errors told them "a lot" about the quality of hospitals and health plans. But overall, few consumers—only 12%—said they used available information on the quality of health care. Nearly three fourths (73%) did not see any such information, and 15% saw but did not use it. Of 315 who saw information about the quality of hospitals, 29% said they used it.

The survey findings were presented at a December conference on strategies for communicating about health care.

Consumers were asked what is important in determining the quality of health care and how concerned they are about injury or harm from a serious error or mistake while receiving health care. Seventy-one percent were somewhat or very concerned about harm during health care; 56% expressed this level of concern about serious errors in prescriptions filled at a pharmacy. In comparison, 53% were concerned about harm during air travel and 54% about harm from eating food purchased at a supermarket.

Keys to quality. More than half (55%) of the respondents said there were "big differences" in the quality of care among health plans that offered coverage in their areas, and 47% said there were big differences in quality among local hospitals. Reports of errors, cited by 69% of respondents, led the list of factors "telling a lot" about hospital quality. Fewer consumers cited hospital quality indicators such as the number of patients not receiving standard recommended treatments (e.g., aspirin after heart attack)—51% of respondents said this told a lot, accreditation status (47%), whether a hospital is a teaching hospital (44%), and whether it has been rated "best" by a local newspaper or magazine (29%). If presented with a choice between two hospitals, 62% said they would choose the one that is familiar and 32%, the one that is rated higher.

Medical errors. Six percent of the consumers reported that they had suffered harm from a medical error in the past 12 months. People with a chronic disease or disability were more likely to report this experience (14%, versus 5% of those without a chronic disease or disability). A panelist at the conference cautioned that these answers were based on the consumers' perceptions. Of people who said they had had difficulty communicating with a health care provider, 13% reported that they had experienced a medical error in the past year, compared with 5% of those who had not had communication problems.

When asked about how errors that result in serious injury or harm should be handled, nearly three fourths of the consumers (73%) took the position that the government should require health care providers to report all serious errors so that this information is publicly available. One fifth (21%) said reporting should be voluntary to protect the patients and staff involved.

Prescription errors and drug information. One third (34%) of the respondents said they were very concerned about injury from a prescription error. This concern seemed more prevalent among respondents with a chronic disease or disability—43% were very concerned about errors in prescriptions filled at a pharmacy—than among the relatively healthy respondents—33%. For accurate information about prescription drugs, 76% of the consumers said they placed "a lot" of trust in their physician, 70% in their pharmacist, and 48% in the printed information included in the package. Only 9% placed this degree of trust in drug information on health Web sites.

Sponsors. The telephone survey of 2014 adults was conducted between July 31 and October 9, 2000, by Princeton Survey Research Associates for the Kaiser Family Foundation. The federal Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, Health Care Financing Administration, and Office of Personnel Management and the California HealthCare Foundation sponsored the December 11–12 conference.