Multiple Conditions, Better Care?

June 13, 2007 -- People with several chronic conditions may get better medical care than other patients, a new study suggests.

The study appears in The New England Journal of Medicine.

Data came from three studies that together included 7,680 U.S. patients.

The quality of medical care was based on whether or not patients with chronic conditions including asthma, heart disease, depression, and diabetes were offered recommended medical services.

For instance, people newly diagnosed with type 2 diabetes should receive counseling about diet and exercise. If that happened, that was a sign of higher-quality medical care, note the researchers.

They included Takahiro Higashi, MD, PhD, of Japan's Kyoto University and Paul Shekelle, MD, PhD, of Rand Health in Santa Monica, Calif., and the Veterans Affairs Greater Los Angeles Healthcare System.

Medical Care Quality

Before the study started, the researchers reasoned that medical care quality would be lower for patients with more than one chronic condition.

But instead, they reached the opposite conclusion.

First, the researchers pooled the data from all three studies. Next, they crunched the numbers to gauge the quality of the medical care the patients received, based on recommended services.

"The quality of care increased as the number of medical conditions increased," write Higashi and colleagues.

For every additional condition patients had, the quality of their medical care rose by about 2%, the study shows.

The reasons for that pattern aren't clear, but the researchers suggest several possibilities.

Perhaps patients with several conditions see doctors more often and thus have more chances to be offered recommended services.

Patients with multiple conditions who see specialists may also "advocate more effectively for the care they need, write the researchers.