Challenges in Health Care Quality

Tremendous geographic variation in the use of clinical procedures suggests the scope of quality deficiencies. Relying on a growing body of research, quality experts have identified three other principal indicators of quality problems:

Error Rates. Inadequate diagnosis and treatment cause unnecessary mortality and morbidity, increasing the burden, complications, and cost of treatment.

An estimated 180,000 deaths are caused each year by medical error.

An estimated 30 percent of acute care patients and 20 percent of chronically ill patients receive care that is contraindicated.

Overtreatment. Millions of patients receive treatments each year that they do not need, leading to complications, reduced productivity, and significantly higher costs. Experts estimate that approximately 20 to 30 percent of health care treatments are unnecessary.

Overuse has been well documented for numerous types of invasive surgery and tests; an estimated 16 percent of hysterectomies and 17 percent of coronary angiograms performed each year are unnecessary.

Undertreatment. Studies consistently show the failure to provide effective treatments, ranging from life-saving interventions that can reduce mortality, such as taking aspirin to lower the risk of heart attack, to vaccinations that prevent serious illness in the elderly and children.

Only an estimated 50 percent of patients receive recommended preventive care.

Among individuals suffering from depression, 59 percent are not treated and 19 percent receive ineffective treatment, leading to an estimated $12 billion annual loss in employee productivity.