Researchers evaluating whether the quality of outpatient care has improved report that it has, but in fewer than half of the nine composites of clinical quality they examined.
Comparing data from the Medical Expenditure Panel Survey for 2002 and 2013, they found that composite scores (which were based on 39 quality measures) improved significantly in four areas: recommended medical treatment (from 36% to 42%), recommended counseling (from 43% to 50%), recommended cancer screening (from 73% to 75%) and avoidance of inappropriate cancer screening (from 47% to 51%).
Composite scores worsened significantly in two areas—avoidance of inappropriate medical treatments (from 92% to 89%) and avoidance of inappropriate antibiotic use (from 50% to 44%). Scores remained unchanged in the other three areas: recommended diagnostic and preventive testing (76%), recommended diabetes care (68%) and avoidance of inappropriate imaging (90%).
Patients’ perception of their care experience, however, improved, with 77% rating their experience for overall care an 8, 9 or 10 out of a possible 10, up from 72%. More patients also said they “always” have access to care (from 48% to 58%) and have good communication from their physician (from 55% to 63%). All three improvements were statistically significant.
The researchers pointed out that the Affordable Care Act was not fully implemented during the period they assessed.
The study results were published online Oct. 17 by JAMA Internal Medicine.