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Elderly Patients' Ratings of Health Care Quality Unreliable

Patients' lack of understanding of technical quality of care skews findings

TUESDAY, May 2 (HealthDay News) -- Frail and elderly adults' global ratings of health care quality may not take sufficient account of technical quality and should be supplemented with independent evaluations, according to a study in the May 2 issue of the Annals of Internal Medicine.

John T. Chang, M.D., M.P.H., of the David Geffen School of Medicine at the University of California Los Angeles, and colleagues conducted an observational cohort study of 236 vulnerable older patients identified from a random sample of community-dwelling adults aged 65 or older who had received care in two managed care organizations over the previous 13 months.

Survey questions rated patients' opinions of health care and provider communication. Quality indicators were used to measure technical quality of care for 22 clinical conditions, and additional quality indicators were evaluated from chart and patient interview data.

While patients gave higher global ratings of health care where there had been better communication, there was no association between technical quality and global ratings of care.

"These results suggest that global ratings of care should not be used as a marker of technical quality of care. Comprehensive assessment of quality of care requires measurement of both patient evaluations of care and technical quality," the authors conclude.

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