Report finds gaps in health care quality

The good news: More physicians are following guidelines to improve patient compliance with treatment.

By Andis Robeznieks, AMNews staff. Oct. 18, 2004.

The National Committee for Quality Assurance's recent annual report found that between 42,000 and 79,000 avoidable deaths are caused by gaps in health care quality.

But the report contained a bit of good news as well: For the fifth year in a row, NCQA's measures indicated that more physicians were following evidence-based guidelines in areas such as managing chronic conditions, administering recommended immunizations, screening for cancer and providing beta-blocker treatment after heart attacks.

The NCQA study includes information on the use of its Health Plan Employer Data and Information Sets (HEDIS) measurements by 563 reporting health plans covering more than 69 million people. Gains of about 4% were reported for evidence-based guideline adherence in several key measures such as controlling high blood pressure and controlling cholesterol. In all, improvements were seen in 41 out of 43 measures.

Although some may view adherence to guidelines as a threat to physician autonomy, some doctors who have received NCQA recognition report that the guidelines help them with self-assessment and with patient compliance with treatment recommendations.

The result of these improvements, said NCQA President Margaret E. O'Kane at a recent press conference, was that "a lot of lives were saved and [a lot of] misery prevented."

O'Kane added that there is a huge differential between the best performing plans and the rest and that there are no data available for the 45 million Americans without health insurance.