Metrics for Health Care Quality that are Important to an Average American.

First, lets go through definitions:

  • Metric: a number or category.
  • Health Care: a service that is provided to an average American who seeks help for treatment or prevention of health condition.
  • Average American: a hypothetical portrait that describes average person in America.

What health care metrics would be important to an average American?

One way to approach this is to look at current professional literature out there. Words and terms like “accessibility,” “reducing social disparity,” “meaningful use” start surfacing in the articles. While professionals and policy makers are very comfortable discussing such terms, these are likely not very meaningful to someone who is seeking treatment for an ache or common cold.

So, is there another way? It would be nice to find a large survey of population with free style write-in responses and tabulate what floated to the top. Perhaps such survey already exists, but it is not at the top of search results in PubMed, Scopus, or Google. So, we must resort to judgement calls and hints.

Personal experience tells us that “I liked my nurse, doctor, technologist,” “I liked this hospital, clinic, surgery center” are common ways patients describe their experiences. These would be easily assessed by asking to answer similarly worded survey questions after a service is provided. Press Ganey (R) scores do that, but there are limitations with this approach. It would be important to time such survey not too soon and not too late after an encounter.

Another way is to look at advertisements. Apparently, “our current wait is 5 min” is an approach that works for those who advertise urgent care centers. Sounds like wait times are important to people.

Here comes the main question. Today, we have numerous metrics that have been published in the context of health care quality. These include mortality and disease rates, patient educational milestones, fluoroscopy dose reports, and meaningful use of EMR, to name a few. It is highly doubtful that an average patient would find those useful. So, lets use what patients seem to consider important: “wait times” and “like/did not like” satisfaction survey questions. Will the quality of health care be rated higher today compared to, say, 1970s-1980s? It seems that patients mostly care if they got service in a timely fashion and whether they liked the place and its people.

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