Patients Complain More about Paperwork than Care
Library: MED
Keywords: PATIENT COMPLAINT PAPERWORK BILLING HEALTH CARE
Description: Patients complain more often about paperwork and billing concerns than the quality of their health care to their health care providers, even though quality related problems are just as common as administrative issues, a new study suggests. (Milbank Quarterly, Dec-2002)



For Immediate Release
Jan. 2, 2003

PATIENTS COMPLAIN MORE ABOUT PAPERWORK THAN CARE

BY BECKY HAM, STAFF WRITER
HEALTH BEHAVIOR NEWS SERVICE

Patients complain more often about paperwork and billing concerns than the quality of their health care to their health care providers, even though quality related problems are just as common as administrative issues, a new study suggests.

Many people don't complain even when they experience serious problems, and recent government regulations set up to make it easier to file grievances with health plan providers have not increased complaints, according to Mark Schlesinger, Ph.D., of Yale University School of Medicine and colleagues.

"Our findings provide substantial evidence that problems involving medical care are less adequately protected by grievance mechanisms than are those related to administrative concerns," the researchers say.

Since many of these state and federal grievance regulations were designed specifically to protect the quality of medical care, "this finding is ironic and not particularly reassuring," they add.

The study found that people who complained were five times as likely to have their concerns successfully resolved. Along with administrative complaints, patients were more likely to take issue with simple problems over the complex, and repeated and costly problems. Patients were also more apt to complain and get their dispute resolved when a third party, like a family member, doctor or outside mediator was involved.

The report, published in the December issue of the Milbank Quarterly, is based on data from the 1999 Kaiser Family Foundation's National Survey on Consumer Experiences with Health Plans. Slightly more than half of the survey respondents reported at least one problem attributed to their health care plan in the past year. Fifty-nine percent of those people complained directly to their health plan and 13 percent complained to their employer.

Blacks and Asians were half as likely to complain about problems than whites, although their complaints were just as effective. A patient's age, socioeconomic status or education did not significantly affect his or her tendency to complain.

Contrary to expectations, patients with chronic or severe illness did speak up about problems they encountered with their plan, although complaints from people with severe illness were often less effective than those coming from more healthy individuals, say the study authors. Previous researchers had speculated that debilitating illness might keep individuals from voicing complaints, due to lack of energy or fear that their coverage might be jeopardized.

The study results also revealed that patients were more apt to complain to their health plan if they believed that the plan administrators were friendly and would respond to problems. This makes it harder to judge a plan's performance by the number of complaints it receives, say the researchers.

"The more extensively state regulators assess a plan's performance in terms of frequency of complaints, the stronger the incentive is for plan administrators to create an image of aloofness and unresponsiveness to their members," Schlesinger and colleagues say.

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FOR MORE INFORMATION
Health Behavior News Service: (202) 387-2829 or www.hbns.org.
Interviews: Contact Mark Schlesinger, Ph.D., at (203) 785-4619.
Milbank Quarterly: Contact Bradford H. Gray, Ph.D., at (212) 822-7287.