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Results of a consumer survey on patient safety present both an opportunity and a challenge to make health care safer

Five years after a groundbreaking Institute of Medicine report focused attention on medical errors in hospitals, the results of a new survey show that Americans do not believe the Nation's quality of care has improved. Four in 10 (40 percent) people surveyed said the quality of health care has gotten worse in the past 5 years, while one in six (17 percent) said the quality of care has gotten better. Nearly four in 10 (38 percent) said it has stayed the same.

Nearly half (48 percent) of those surveyed said they are concerned about the safety of the medical care that they and their families receive, and more than half (55 percent) said they are dissatisfied with the quality of health care in this country—up from 44 percent who reported the same in a survey conducted 4 years ago. People with chronic health conditions were considerably more likely than other consumers to express concerns about their quality of care and to report having personal experiences with medical errors.

The survey, which involved 2,012 adults, was conducted by telephone from July 7 to September 5, 2004. It was supported by the Henry J. Kaiser Family Foundation, the Agency for Healthcare Research and Quality, and the Harvard School of Public Health.

These perceptions exist despite efforts by hospitals, doctors, health plans, and purchasers to reduce medical errors and improve the quality of care in the wake of the 1999 Institute of Medicine report, To Err is Human: Building a Safer Health System. This IOM report concluded that hospital-based medical errors were the eighth leading cause of death in the United States, and that the primary cause was problems with the health system itself rather than the performance of individual doctors, nurses, and other providers.

The survey results reveal a great deal about patients' concerns and emphasize the need to communicate more effectively about what is being done to improve the quality and safety of the Nation's health care system. Many of the system-related improvements that have been made to improve patient safety—such as the use of computerized order entry in hospitals and better physician staffing in emergency rooms—are largely transparent to patients and their families. The challenge is to show the connection between these kinds of changes and improvements in the care patients receive, while at the same time expanding and accelerating these efforts.

For more information, select National Survey on Consumers' Experiences with Patient Safety and Quality Information.

Editor's Note: In addition to the new survey, Kaiser Family Foundation President Drew E. Altman, Ph.D., AHRQ Director Carolyn M. Clancy, M.D., and Robert J. Blendon, Sc.D., Professor of Health Policy at Harvard School of Public Health, collaborated on a perspectives column that examines patient safety efforts and public opinion trends. See "Improving Patient Safety—Five Years After the IOM Report," in the November 11, 2004, New England Journal of Medicine, 351(20), pp. 2041-2043.

Reprints (AHRQ Publication No. 04-R017) are available from the AHRQ Publications Clearinghouse.

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