Multiple Conditions, Better Care?
Patients With Several Chronic Conditions May Get Higher-Quality Medical 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
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.