Does Managed Care Cause Medical Errors?

Published March 1, 2001

Managed care programs restrict patient and physician choices in order to lower prices paid by employers and minimize unnecessary procedures. While such programs have clearly produced some benefits—they are generally credited with slowing the growth of health care spending in the mid-1990s—they have also generated costs in the form of more paperwork and a diversion of personnel away from direct interaction with patients. The size of these costs is a matter of some controversy.

To highlight the deteriorating working conditions for its members (registered nurses, or RNs), the American Nurses Association (ANA) released a national staffing survey in February 2001 that adds some new information to the debate. Among the findings from over 7,000 nurses interviewed:

  • 75 percent of the nurses surveyed said the quality of nursing care at the facility where they work has declined over the past two years.
  • 56 percent said the time available to care for patients has decreased.
  • 54 percent of nurses surveyed would not recommend their profession to their children or friends.

“The responses we have received from nurses who took this survey are alarming,” said ANA President Mary Foley, MS, RN. “With over three-quarters of respondents believing that the quality of nursing care has declined and more than half saying their time for patient care has decreased, consumers should be concerned about the quality of health care they are receiving. And if four in 10 nurses would be hesitant for a family member to be cared for in their own facility, that sends a red flag to the American public that something is definitely amiss in our nation’s health care facilities.

“If we hope to maintain the quality of care in our health care facilities, we must improve nurses’ working conditions, which have deteriorated over the last decade. To help achieve that end, ANA is actively calling for legislation that protects patients and nurses, and ensures better care,” Foley added.

The ANA survey results are backed by a February 5 report from the Center for Health Professions at the University of California, San Francisco (UCSF). The UCSF study shows stress in the workplace has increased due to managed care cost pressures.