News Briefs
News Briefs
Do ethnic differences affect physician ratings?
Patients of different ethnic and racial backgrounds tend to vary dramatically in how they rate the performance of their doctors, a study funded by the Agency for Healthcare Research and Quality has concluded.
The study, conducted by researchers of the Kaiser Permanente Medical Care Program in Northern California and the University of Cali-fornia-San Francisco, included reports from 1,007 Asian patients, 836 African-American patients, 710 Hispanic patients, and 7,747 white patients who received care from general internists, internal medicine subspecialists, and family physicians at 13 Kaiser facilities.
The study was designed to evaluate difference in attitudes toward primary care physicians among patients of various ethnic and racial backgrounds.
Some of the conclusions were:
• Asian patients rated the performance of their doctors significantly less favorably than white patients did.
• African-American patients gave physicians use of the latest technology and of psychosocial and lifestyle health promotions a higher rating than white patients did.
• Hispanic patients gave physicians’ accessibility and technical skills a lower rating than white patients.
The researchers say that the study may point out actual difference in the quality of care or that the responses may be due to differences in patient perceptions or expectations. They called for more research to access whether health plans are meeting the needs of a diverse patient population.
Physician practices rate low for many lenders
Lender confidence in the health care industry has sunk to a new low, with 85% of commercial lenders saying they would not lend to a health care concern, according to the latest Phoenix Lending Survey.
More than half of the 95 lenders participating in a survey ranked health care as the least attractive industry among a list of 16 to which they lend. It was the third quarterly survey in which the health care industry was ranked at the bottom of the heap.
Physician practices were ranked as unattractive entity to which to lend by 45% of lenders responding to the survey.
This was the first time the Phoenix survey asked about specific categories within the health care industry.
Not-for-profit hospitals headed the list of health care segments with 56% of lenders saying they were unattractive to their lending institutions. Ratings of other segments were managed care companies, 53%; home health agencies, 45%; and nursing homes, 43%.
Other industries that lenders consider unattractive included start-ups/new ventures, retail, and agriculture/forestry/fishing.
Industries that are attractive to lenders include light manufacturing, industrial distribution, and service companies.
Phoenix Management Services, a Philadelphia-based management firm, conducts its "Lending Climate in America" survey quarterly to gauge shifts in lenders’ attitudes.
Hindsight bias a problem in malpractice suits
Expert witnesses in medical malpractice lawsuits may be overconfident in their conclusions because of a phenomenon called hindsight bias, a University of Ohio professor of psychology has concluded.
"The jury and the expert witnesses are looking back on an event, and they know how it turned out. It biases their perception of what should have been done," says Hal Arkes, PhD, who does research on medical decision making and physician overconfidence.
Arkes, and Neal Dawson, a researcher at Case Western Reserve University in Cleveland, conducted a study of 160 doctors and medical students to determine if hindsight bias would affect a diagnosis.
Foresight vs. hindsight
In the study, half of the participants were asked to complete a questionnaire after the case was presented but before the cause of death was revealed. This group, called the foresight group, was given a list of five possible diagnoses and asked to assign a probability that each was the correct answer. The other group of participants, the hindsight group, was asked to fill out the same questionnaire after the pathologist revealed the actual diagnosis.
People in the foresight group were less likely to select the correct diagnosis than those in the hindsight group.
"In hindsight, we underestimate how difficult the task was in foresight. It’s unfair in hindsight to evaluate people who had only a foresight perspective," Arkes says.
Employers report rising health care costs
Health care premium costs are rising by 9.7% in 2000, according to a survey of 503 employers representing 18 million employees and dependents.
However, the 953 health care providers responding to the same survey say the average fee schedule for services they provide is rising only 3% this year.
The survey was conducted by Watson Wyatt Worldwide and the Washington Business Group of Health with assistance from the Healthcare Financial Management Association.
The 6.7% difference between provider fees and plan costs to employees reflect two trends: changing utilization patterns and mix of services, and efforts by health plans to improve their profitability, says Rich Ostuw, global practice director of group and health care consulting at Watson Wyatt at its U.S. corporate office in Bethesda, MD.
According to the survey, 70% of employers are passing some of the increased medical costs on to the employees. Nearly all (99%) of the 69 major health plans responding to the survey report passing on increased costs while only 53% of providers say they are passing on cost increases. At the same time, employers are providing more information to employees to help them choose the right health plan.
"Employers are following a two-track strategy to combat prices increases. In addition to redoubling efforts to manage the vendor relationship for better results, they are preparing employees to be better health care consumers," Ostuw explains.
Other results of the "Fifth Annual Survey of Employers, Health Care Providers and Health Plans" are available at the Watson Worldwide Web site: www.watsonwyatt.com.
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