Men, women perceive quality with different measuring sticks

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Measuring healthcare in terms of quality is a relatively new concept, one in which even the biggest payer in the country admits is a work in progress.

One initial lesson is that the word "quality" means different things, depending on whom you ask. In a recent survey of 374 new patients with early-stage breast cancer, for example, researchers discovered that the women's idea of quality varied greatly from the medical definitions of the term used by hospitals, Reuters reported.

For the most part, the patients rated the care they got as of lower quality than their medical records indicated they received. In particular, just 55 percent said the care they received was "excellent," although 88 percent actually got good-quality care according to medical guidelines, the study indicated. Among those who did rate their care as excellent, most also highly rated their process of getting care, as well as being treated well by medical staff.

Black women, who received the same clinical treatment as both Hispanic and white patients studied, were even less likely to report receiving excellent care (39 percent), the authors found, noting that they were more likely to perceive racism in the process of getting care.

A separate study published earlier this year in the journal Health Services Research looked at the differences in perceptions of care between men and women.

Whereas the breast cancer study compared a group's perceptions against written guidelines, this one directly compared two groups of people (men versus women). But once again, women turned out to be the more critical sex. As noted by the New York Times, women tended to be less satisfied with staff responsiveness, their discussions with nurses, communication about medications and discharge plans and cleanliness and hygiene issues, whereas men were generally more positive about their experiences.

The lesson, according to Marc N. Elliott and colleagues, is not that female patients are harder to please, but that "[r]eal quality improvement is not one-size-fits-all."

To learn more:
- read the article from Reuters
- see the study from the Journal of Clinical Oncology
- read the post from The New York Times
- see the study from Health Services Research

To learn more:
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