AHRQ releases data on patient experience

First-year data to act as benchmark for future

It’s only the first year, but the Agency for Healthcare Research and Quality (AHRQ) hopes that data collected on patient experiences in the health care system will prove useful to health care organizations in the future.

The data, taken from a questionnaire incorporated into the AHRQ Medical Expenditure Panel Survey, cover issues such as how fast patients get needed urgent care, how quickly they can get an appointment with a physician, and how patients felt about their experience. How a patient felt about the visit includes whether the physician spent enough time with them, whether they felt their doctors listened to them, how respectful the care giver was, and how well their care was explained.

Among the findings of this first-year data:

  • Timeliness of urgent care. Slightly more than half of Americans age 18 and older (53.8%) who do not live in institutions or serve in the military always received urgent medical care as soon as they wanted it in calendar year 2000.

There was minimal difference in this between African-American and white patients, but only 41.2% of Hispanic patients reported receiving urgent care when they wanted it.

Those without insurance are more likely to report not getting urgent care when they wanted, and those with public insurance such as Medicaid, also lagged behind their privately insured counterparts in this area (28.6% of the uninsured, compared to 19.1% of the publicly insured, and 16.1% of those with private insurance).

  • Patient experience during treatment. Nearly three fourths of the adult population in the United States visited a doctor or clinic in 2000. And the vast majority (82.6%) reported no problems receiving the care they or their doctor believed was necessary. Even more (89.8%) said their health care providers always or usually listened carefully to them; and 84% said their health providers always or usually spent enough time with them.

There were racial differences in the latter category, however. African-Americans were the most likely to say their providers explained care well to them. White patients felt this was true 58.6% of the time, and 53.1% of Hispanics thought so.

More than half (58.6%) of patients say that their care was adequately explained, but nearly 10% felt that their providers sometimes or never explained care in a manner that they understood. Older patients seemed happiest with the explanations they got. (To see Graph 1, click here.) And those without insurance also were less likely to get adequate explanation of their care.

Patients surveyed said caregivers nearly always treated them with respect, with more than 90% of patients saying that was so always or usually. Only 9.8% of patients reported that physicians sometimes or never treated them with respect. And the older the patient, the greater the respect accorded to him or her, says the survey. (To see Graph 2, click here.)

  • Access to care. Fewer than half of all those surveyed (43%) said they always received an appointment at a clinic or doctor’s office as soon as they wanted. But people age 65 and older (54.7%) were more likely to say they always obtained an appointment as soon as they wanted than those age 18-64 (40%). Those with private insurance also cited fewer problems getting appointments when they wanted, with 84.5% saying it wasn’t difficult getting needed care, compared to 71.5% of those with public insurance, and 72.9% of the uninsured.

No surprises — yet

Because this is the first year the data were collected and published, there weren’t really any statistics that caused surprise, says Steven Cohen, PhD, director of AHRQ’s Center for Cost and Financing Studies. "What we found seems to compliment other studies that have been done," he says, noting this particularly is true for what the statistics say about the uninsured.

Cohen says he was gratified to see that the elderly seem to have a fairly consistent pattern that shows they are getting more time with their care and have adequate access to it. "But what will really be informative is when we do this again next year and see if there is any consistency and what the direction of trends are."

The goal of this data is to provide national standards for health care delivery systems that are interested — and should be interested — in the experience patients have within the broader health care system. "This survey is a national resource," Cohen says. "After we have data on more than one year, we will be able to determine what actions need to be taken. You have to remember, too, that this is a perception of care from patients. But we will see what the trends are and benchmark."

Among the things he hopes health care organizations will look at is the access data compared to emergency room utilization data. If emergency department use is increasing, and access is declining, then organizations will have to look and see if there is a link.

While this set of data related solely to adults, Cohen notes that in the next month or so, AHRQ will have similar data available for pediatric patients. Meanwhile, a second set of data on adults covering 2001 visits will be available next February.

[Editor’s note: The entire survey can be found at the AHRQ web site at www.meps.ahrq.gov/papers/st2/stat02.htm.

For more information, contact:

  • Steven Cohen, PhD, Director, Center for Cost and Financing Studies, Agency for Health Care Research and Quality, 2101 E. Jefferson St., Suite 500, Rockville, MD 20852. Telephone: (301) 594-6171.]