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Public's Definition of Quality Focused on Medical Errors

The Institute of Medicine's report on medical errors, in a perverse way, has focused public attention on quality of care. A survey jointly sponsored by the U.S. Agency for Research and Quality and the Kaiser FamilyFoundation has found that information about medical errors and malpractice suits is what people find to be most helpful when determining provider quality.

Americans have long professed an interest in quality of care, but surveys suggest that they are unable to reach a consensus on what quality means. Quality experts bemoan evidence that people pay little attention to standardized quality indicators, such as HEDIS ratings and physician report cards, and that they rely primarily on word of mouth when selecting providers and plans.

The new survey confirmed the word-of-mouth phenomenon, but with the IOM report fresh in the public's mind, 71 percent of those surveyed rated medical-error rates as an important indicator of provider quality. Malpractice information was close behind, at 70 percent. For health plans, programs to help people with chronic illnesses (67 percent) and ease of getting referrals to specialists (66 percent) were the most-often-cited indicators of quality. Only 1 in 10 Americans has used standardized information to compare quality of health plans, doctors, or hospitals when making health care decisions.

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