The
difference between quality of service and quality of health care can be confusing, as both
are oriented toward the public welfare and the provision of the most positive experience for the
patient as possible. The distinction, however, does exist, and using standard quantitative
analytical methods can be useful in improving public perceptions of this distinction.
Quality of health care is a more dispassionate, objective concept than quality of
service. Quality of health care is a broader macro topic that addresses public-wide health
care issues, such as rates of vaccination, diagnostic screenings, and other preventive measures,
as well as restorative measures like surgical procedures and lifestyle changes. The latter is
important in addressing obesity and substance abuse issues.
The US Centers
for Disease Control and the National Institutes of Health are instrumental in measuring outcomes
of such factors. Through methods such as public surveys, they collect, examine, and analyze a
large amount of data. Quality of health care can be measured through data that tracks all
kinds of health-related issues, much of which can be ascertained through medical records and
patient surveys (e.g., are you a smoker?, how much alcohol do you consume on a weekly
basis?, how much do you exercise?, etc.) Additionally, data associated with the provision of
health care, such as success rates for various medical procedures, can be factored into the
equation.
Quality of service, in contrast to quality of health care, is
more subjective and often hinges on emotional responses to interactions with the health care
industry. For example, whether a patient feels that his or her concerns were adequately
addressed is an element of this discussion. It is important to recognize that an
emotionally-positive experience does not necessarily equate to a successful medical outcome.
Physicians are like any other category of humanity. There are the good, the bad, and the ugly
practicing medicine. A stereotype, with some foundation (having spent the past four years
working in a hospital), is that of a gifted physician or surgeon with a notoriously unpleasant
demeanor. The medical outcome may be positive, but the emotional response to the physicians
personality (or bedside manner) may be entirely negative. As emotions contribute to overall
health, this is not an inconsequential consideration.
Now, how can
perceptions of the quality of health care and of quality of service be changed through the use
of survey research? By the above-discussed use of adequately-worded public surveys that
distinguish between the two concepts. Many patients will obviously and logically rank medical
outcome over perceptions of provider temperament. After all, many people would think what do I
care if the doctor was rude and uncaring if he cured my condition?
Satisfaction with the quality of health care, though, is a product of satisfaction with
the quality of service, and surveys can be drafted to address this distinction. Negative
experiences interacting with health care providers can deter individuals from following up on
medical complaints, which can lead to negative medical outcomes for the patients. Doctors,
nurses, phlebotomists and other staples of the health care environment are human beings and
subject to the same kinds of irritants as anybody else. They are, however, required to act as
though their personal travails are extraneous to the concerns of the patients for whom they are
caring. Additionally, and strictly as a business matter, negative patient experiences can compel
patients to seek alternative sources of medical care. For this reason, it is in an individual
health care facilitys interest to track customer satisfaction through surveys, which are a
routine practice.
Once data is collected and collated on patient experiences,
and once that data is merged with objective analyses regarding health care trends (the data
accumulated by the CDC and NIH), the public can better understand the difference between
quality of health care and quality of service. How important will be those findings to the
public is a matter for the individual.
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