Indifference To Hospital Quality
Consumer pressure for quality in medicine is very weak. How weak? Consider that readers of Consumer Reports are unusually wealthy and assertive as customers, and readers who answered a Consumer Reports survey are probably especially so. Yet when such folks had a choice of hospitals, only 2% listed a hospital rating among their top three reasons:
Fifty-nine percent of patients in our survey did not enter the hospital through the emergency room, so they might have had a choice of which hospital to go. But 65 percent [of these] simply went to the hospital their physician recommended or was affiliated with. Forty percent chose a hospital for its location, and 28 percent because it was in their health plan’s network. (Respondents were asked for their top three reasons.) Only 11 percent chose the hospital for its record in treating their condition, and only 2 percent on the basis of the hospital’s ratings in books or magazines or online. (Consumer Reports, September 2009, “Patients Beware,” pp. 18-23.)
I suspect most of that 11% of patients were actually just relying on their physician’s claim about a hospital’s record, rather than checking it out for themselves. Consumer Reports also surveyed 731 hospital nurses, 26% of who said their staff is lax in washing hands, vs. 5% of patients who said so:
To help prevent hospital infections, the national Centers for Disease Control and Prevention says that doctors or nurses should wash their hands (or use alcohol gel) in front of you when they enter your room, and if they don’t you should remind them. Many hospitals have campaigns to encourage patients to speak up in that way.
Do it!
The comment was from John Thacker at 1:20 this afternoon, I intended to include that attribution, then forgot until I hit the post comment button.
Robin, this is a bit off-topic for this post, but it's the only recent medical economics post I've seen, so here goes: a commenter on Megan McArdle's blog came up with a good question:
That brings up another point: What do the calculations of "percentage of GDP spent on health care" cover? If one system, like the US, has doctors paying high tuition at medical school, which is then passed on to consumers as higher health care costs, but another system has doctors' tuition paid "for free" out of other tax money, do these comparisons count the subsidized doctor education as part of "health care costs?" Or is that slid into "these countries spend more on education and less on health care?" Similarly, if a country decides that it wants to research pharmaceuticals through government research instead of using the profit system, are the taxes used to pay that counted as "health care costs" or as "this country saves on health care costs so it can spend more on science and research?"Maybe you could get some of your students to research it, like Lomborg got his students to examine some of Julian Simon's claims he had doubts about.