Massachusetts Patients Offer Feedback on Their Experiences With Primary Care
Patients in Massachusetts give their primary care physicians high marks for communicating effectively and for showing them respect, according to the results of a statewide survey released today by Massachusetts Health Quality Partners (MHQP). However, the survey also found wide variability in results among primary care practices, and significant opportunities for improvement in key aspects of patient care, such as always informing patients of test results, coordinating care between primary care physicians and specialists, and advising adults about preventive care.
Four out of five adult patients surveyed by MHQP reported that their Massachusetts primary care physicians always provided clear explanations, listened carefully, and offered clear instructions during office visits, and an even higher percentage of parents said the same of their children’s pediatricians. Parents also gave their children’s pediatricians high scores for reminding them of the need for routine preventive care such as immunizations, lead screenings and eye exams, with almost nine out of ten saying they had been reminded within the past 12 months. At the same time, 30 percent of those surveyed said their doctor’s office did not always follow up with test results for themselves or their children, and more than 20 percent of adult patients said their primary care doctor did not remind them of important preventive care they were due to receive, such as immunizations, flu shots and screening tests.
Last fall, 51,000 adult patients and 20,000 parents of pediatric patients responded to an MHQP survey about their experiences with primary care during the preceding year. The resulting report, Quality Insights: Patient Experiences in Primary Care, is available at mhqp.org in a format that allows Web users to look up and compare the results for more than 400 adult and pediatric primary care practices by name or location.
The survey asked patients about aspects of their health care experience that are closely linked to quality of care and the strength of the doctor-patient relationship, according to Barbra Rabson, executive director of MHQP.
“The participants in our survey were asked to assess their care along multiple dimensions that are important to patients and that affect the quality of care they receive — like how well their doctors listen to and communicate with patients, know their patients’ medical histories, and coordinate patients’ care,” Rabson said. “These are essential elements of an effective, patient-focused primary care visit, because when patients have positive experiences at their doctors’ offices, they are more likely to develop trusting relationships and follow medical advice.”
A wealth of information for consumers
The new Patient Experiences report follows closely the release of MHQP’s fourth annual Quality Insights: Clinical Quality in Primary Care report, which is also available at mhqp.org. The Clinical Quality report, released in April, is based on standardized quality data collected about medical groups across the state to rate how well primary care physicians in those groups provide preventive care and help patients manage chronic conditions. Taken together, the two Web-based reports give Massachusetts consumers unprecedented tools for easily comparing the performance of primary care medical practices.
“MHQP and the participating physician practices and health plans have shown exceptional leadership and courage in affirming the partnership role that consumers play in reporting and guiding care, and for the enormous educational and improvement value of healthcare transparency,” said James Conway, who is Senior Vice President at the Institute for Healthcare Improvement and a member of the Massachusetts Health Care Quality and Cost Council. “As the nation looks to Massachusetts for leadership in health reform, it is fitting that they see a state, without peer, where consumers are given a comprehensive, objective picture of primary care both from the patient’s perspective and from data on clinical quality.”
Variations highlight opportunities for improvement
The MHQP survey found significant variations among different physician practices in how patients assessed their primary care experiences, with differences as high as 36 percentage points from the highest to lowest performing. In addition, despite the overall high performance scores in many aspects of the patient experience, the report pinpoints opportunities for continued improvement in others. For example:
— While adult patients gave their physicians high scores for various aspects of communication, scores were significantly lower for how well doctors know their patients, including their medical history, values and beliefs; how well doctors coordinate patients’ care with specialists; how well doctors follow up on test results; and whether doctors ask their patients about stress and possible depression.
— Many primary care doctors in Massachusetts work in teams, and about half the adults in the survey evaluated care they had received from a doctor or nurse other than their primary care physician. Overall, patients gave higher marks to care they received from their own doctor than from other doctors and nurses in their doctor’s practice. For instance, 83% said their own doctor always explained things clearly, while 56% said other clinicians always did; similarly, 74% said their own doctors always spent enough time with them, while 56% said other clinicians in the practice always spent enough time.
“Choosing a personal doctor is an important decision, and these reports give patients a valuable perspective on the delivery of health care through the eyes of other patients. Physicians also gain valuable insights from these reports, as they seek to give their patients the best care possible,” said Bruce S. Auerbach, MD, president of the Massachusetts Medical Society.
Massachusetts Health Quality Partners is an independent, not-for-profit organization established in 1995 by a group of Massachusetts health care leaders who identified the importance of using objective, comparable quality measures as a way to drive improvement. Its membership reflects a broad-based coalition of physicians, hospitals, health plans, purchasers, consumers, government agencies and academics working together to promote improvement in the quality of health care services in Massachusetts. MHQP provides reliable information to help physicians improve the quality of care they provide their patients, and help consumers take an active role in making informed decisions about their health care.
Additional information about Quality Insights: Patient Experiences in Primary Care
The MHQP patient experience survey was conducted in the fall of 2007. More than 400 primary care adult and pediatric practices (with three or more physicians) and 3,500 physicians are included in the survey data, comprising the majority of primary care physicians in Massachusetts.
In this report MHQP collects and analyzes patient experience performance data for patients covered by Blue Cross Blue Shield of Massachusetts, Fallon Community Health Plan, Harvard Pilgrim Health Care, and Health New England. These plans also provide funding support.
The MHQP report is based on what patients say about their actual experiences with their primary care physicians, including:
— how well doctors listen to and communicate with their patients,
— how well doctors know their patients’ medical history, values and beliefs,
— how well doctors coordinate their patients’ care with specialists, and
— how well doctors provide preventive care and advice.
The report also assesses how well physicians’ offices handle patients’ access, service and care needs, such as:
— whether patients feel they get timely appointments, care and information,
— how well other clinicians in the practice cared for them, and
— what level of service they get from office staff.
A sample of the statewide findings includes:
— 67 % of adult patients and 73% of parents of child patients reported that their doctor always seemed to know the important information about their medical history.
— Almost 70% of patients reported that someone from their doctor’s office always followed up with test results for themselves or their child.
— 60% of patients (adult and child) reported that their doctor was always informed and up to date about the care they received from specialists.
— 54% of adult patients and 78% of parents of child patients reported that when they called the doctor’s office with a medical question during regular office hours, they always got an answer to their question the same day.
MHQP’s first statewide survey of patients’ experiences with primary care physicians was released in March 2006.
SOURCE Massachusetts Health Quality Partners
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