Monday, April 17, 2006

2388 Bad news for the left

A new study published in the New England Journal of Medicine (354:11; 1147, March 16, 2006) apparently finds that differences among socioeconomic groups makes little difference in the quality of recommended health care. After collecting data for 439 indicators and 30 chronic and acute conditions they learned:

    women had higher scores than men

    younger people (under 31) had higher scores than those over 64

    Blacks and Hispanics had higher scores than whites

    household incomes of over $50,000 had higher scores than households with incomes less than $15,000

    Health insurance was unrelated to differences in quality of care.

It's hard to get grant money if you publish the heresy that gender, age and race don't matter in your health care quality, (or if you poo poo global warming) so I wonder if this group will even get a second chance to dig deeper--and I hope they do. Plus they really had to haul out the excuses and explanations.

    "We were measuring different dimensions or indicators of quality than had previously been studied."

    "When we confined our analysis to indicators used in previous studies, we found better care for whites."

    "Previous studies focused on invasive and expensive procedures rather than routine health care."

    We considered nonresponse bias, but that didn't explain it.

    We even looked at poor record keeping to explain our results.

    We might have missed the most vulnerable and screwed this up because they didn't have phones (paraphrase).

Well, they did their mea culpas and decided that what we really need is to make large scale system-wide changes anyway because veterans (using the VA health care system) were scoring much higher than the general population in quality of health care. So there are problems, but they just couldn't say it was based on income or social class or race or gender.

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