Segal M; Academy for Health Services Research and Health Policy. Meeting.

Abstr Acad Health Serv Res Health Policy Meet. 2002; 19: 37.

Dept. of Health Care, Access and Quality, Research Center for Health Care Decision-making, Inc., 706 Hartwell Lane, Wyndmoor, PA 19038; Tel: (215) 836-2459; Fax: (215) 836-5340; E-mail: msegal2@mail.med.upenn.edu

RESEARCH OBJECTIVE: Investigate consumers' perceptions of the relative importance of health plan quality indicators using a realistic task in which they rank-ordered preferences for nine simulated plans. Each differed systematically on hypothetical members' ratings of four quality indicators not confounded with characteristics of providers: how easy it was for members to 1) get benefits information from customer service (I); 2) fill out required paper work and forms (F); 3) get appropriate specialist care (S); and 4) find and choose a personal doctor (P). We: 1) calculated importance of the indicators using conjoint analysis; 2) determined extent to which specific quality indicators compared to overall quality in preferences; and 3) explored differences in indicators' importance according to consumer characteristics. STUDY DESIGN: Three healthcare websites were examined for indicator ratings of existing plans. Members' favorableness ranged from approximately 50% to 90% in eight of the 10 instances in which indicators were rated; thus in our study, indicators were individually assigned a members' favorableness rating of 50%, 70%, or 90% that varied by plan. Nine simulated plans were produced using a fractional factorial design; each of four sets of plans listed the indicators in one of four orders (randomized Latin square). Coverage/cost was assumed constant. Consumers rank-ordered the four indicators, weighted them relative to cost, and were then handed the nine plans, presented as a set in one of 36 orders (randomized Latin square), to rank-order by preference. A monotonic conjoint analysis model generated part-worths for each indicator level for each consumer. An indicator's importance was derived by determining the range of the three levels' part-worths, and then standardizing the range by dividing by the sum of part-worth ranges for all four indicators. POPULATION STUDIED: Forty-five consumers were recruited from a northwest Philadelphia neighborhood and adjacent suburb. The majority were younger than age 55, Caucasian, and college graduates. PRINCIPAL FINDINGS: Indicator importance for P = .35; S = .31; I = .20, and F = .15. P/S (access/choice) and I/F (service/convenience) were each combined. Mean importance of P/S was .66; I/F, .34 (z=2.08, p=.038). Consumers who had used the health system more intensively ranked P/S lower and I/F higher (Mann-Whitney U=227, p=.048), although mean importance for P/S remained high. For each consumer, derived importance scores were correlated with direct rankings. Average correlation (r-to-z) was .86. Individual consumers' preferences for the plans were correlated with overall quality of each plan, measured as the sum of its quality ratings on each indicator. Average correlation (r-to-z) was .70. CONCLUSIONS: Consumers endorsed the importance of plan quality, in terms of weight relative to cost and the correlation of overall plan quality with their plan rankings. They differentiated among quality indicators: access/choice was significantly more important than service/convenience, although this effect was modulated as use of the health system increased. Ongoing work will compare these results to those for consumers with lower SES and poorer health status, including chronic health conditions. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Importance of choice and access in consumers' preferences for health plans. PRIMARY FUNDING SOURCE: University of Pennsylvania School of Medicine

Publication Types:

• Meeting Abstracts

Keywords:

• Choice Behavior
• Consumer Satisfaction
• Costs and Cost Analysis
• Delivery of Health Care
• Insurance, Health
• Pennsylvania
• Philadelphia
• Physicians
• Quality Indicators, Health Care
• economics
• hsrmtgs

Other ID:

• GWHSR0002446

UI: 102274122

From Meeting Abstracts