Quality of care rises with more medical conditions

NEW YORK, June 14 (Reuters) Contrary to what might be expected, the quality of care that patients receive increases with the number of medical conditions they have, according to a report in The New England Journal of Medicine.

The findings are the result of a study of 7,680 community-dwelling adult patients drawn from three sources: the Community Quality Index study, the Assessing Care of Vulnerable Elders study, and the Veterans Health Administration project.

Quality of care was defined as the percentage of quality indicators that were satisfied for each patient.

With each additional medical condition, the quality score rose by 2.2 per cent for patients in the Community Quality Index study, 1.7 per cent for those in the Assessing Care of Vulnerable Elders study, and 1.7 per cent for members of the Veterans Health Administration project, Dr Paul G Shekelle, from Rand Corporation in Santa Monica, California, and colleagues report.

The strength of the association fell slightly after the data were adjusted for the influence of patient characteristics, healthcare use, and care provided by specialists. By contrast, the difficulty of delivering recommended care had little impact on the quality of care.

Contrary to what might be expected, they found that patients with more medical conditions ''consistently received better technical quality of care for these conditions than did patients with fewer conditions,'' the authors state.

This suggests that a comprehensive and detailed analysis of medical care processes can be used to determine a patient's quality of care ''without creating a disincentive for providers to avoid patients with the most prevalent chronic conditions.'' REUTERS SG RK0930