The Role of Quality Information
Highlights of a National Survey
Americans As Health Care Consumers: The Role of Quality
Information is a nationally representative telephone survey
of 2,006 adults designed by the Kaiser Family Foundation, the
Agency for Health Care Policy and Research (AHCPR), and Princeton
Survey Research Associates (PSRA). It was conducted by PSRA
between July 26 and September 5, 1996. The margin of error is
plus or minus three percentage points.
The full text of the survey results—the Questionnaire and
Toplines—can be downloaded; select for Downloading Information.
In choosing a health plan, Americans say quality of care is
their biggest concern (42%), over low cost (18%), a wide choice
of doctors (17%), and a range of benefits (14%). But, what most
people say ultimately sways their decision are personal
recommendations from their doctors (59%) and family members and
friends (57%), according to a new national survey by the Kaiser
Family Foundation and the Agency for Health Care Policy and
Research (AHCPR) on what information affects Americans' health
care choices, particularly the role of quality.
Seven out of ten (69%) people regard their family and friends
as "good" sources of information about health plans
because they share common concerns. Employers, on the other hand,
are seen less favorably. Nearly six out of ten (58%) say
employers are not a good resource because they cannot be trusted
to provide reliable information about the quality of different
health plans "because employers' main concern is saving
money on health benefits."
When it comes to making health care decisions, a personal
recommendation weighs so heavily with Americans that
three-quarters (76%) would opt to see a surgeon they know rather
than one they don't even if he or she had much higher ratings,
and 72% would go to a hospital they are familiar with over one
rated much higher in quality by the experts. A
majority—52%—also say that if they had to choose
between two plans, they would select the one strongly recommended
by their friends and family over one rated much higher by
independent organizations that evaluate plans.
If they had to find a new doctor, Americans are also more
likely to turn to someone they know for a recommendation: 51%
would ask friends and family, and 57% would get a referral from
their current physician. Furthermore, when choosing a doctor,
Americans are more concerned with how well a doctor communicates
with patients and shows a caring attitude (84%), and whether a
doctor is board certified (71%), than whether the doctor has been
highly rated by an independent organization (25%) or local news
outlet (15%).
Americans' lukewarm reception to quality information produced
by independent organizations could reflect their lack of
familiarity with such information: only two out of five (39%)
Americans say they have seen quality comparisons within the last
year. While most of those who have seen these comparisons say
they think it would be useful for someone trying to make a
decision about health plans (87%), doctors (86%), and hospitals
(83%), far fewer have actually ever used the information in their
own decisionmaking (34% in choosing health plans; 35%, doctors;
and 30%, hospitals). In fact, even those who have seen quality
comparisons are more likely to choose the provider they are more
familiar with when presented with a choice between a health plan,
doctor, or hospital they know or one rated much higher by the
experts. In addition, they, like other Americans, also say they
rely most heavily on the recommendations of friends and family
and their personal physician over that of the experts.
Almost half (45%) of respondents with employer-based coverage
say they are offered only one health plan through their work,
leaving them with no selection of plans to compare and,
understandably, less interested in comparative information. In
fact, those with a choice of two or more plans who had seen
quality comparisons were more likely to use the information they
saw in selecting a health plan (46%).
Still large majorities of Americans say specific information
about quality of care, such as how well a plan cares for members
who have health problems (90%), ease of getting needed care
(88%), and success at early disease detection (87%), are
"very important" to know when choosing a health plan.
Furthermore, given that 47% of Americans—and 57% of those
who have seen quality comparisons—believe that there are
"big differences" in the quality of care among health
plans, there may be future demands for more comparative
information.
What Americans say tells them the most about the quality of
health plans is the ease of access to specialists (68%) and the
range of benefits offered (66%). Other health care quality
indicators that are likely to be meaningful for Americans are
those emphasizing patient experiences and attitudes:
- The percentage of doctors who have had a complaint filed
against them by patients (64% say this tells them a lot
about quality).
- The percentage of plan members who get regular preventive
health care screenings (62%).
- The percentage of members who change plans because they
are dissatisfied (61%).
- How patients rate their plan's doctors (58%).
- How patients rate the overall quality of their health
care plan (57%).
Patient satisfaction surveys are one of the sources of
information on quality of health plans that Americans find most
influential after their regular doctor, and friends and family
(45%).
Most Americans—88%—believe there is a role for the
government in the quality of health care arena. A majority (52%)
think the government should both monitor health providers to
ensure a minimum standard of quality and make sure information
about quality is available to the public. Another 24 percent
think the government should only make sure information is
available so people can make judgments about quality themselves,
and 12 percent say the government's only role should be to
monitor for a minimum standard of quality of care.
The Henry J. Kaiser Family Foundation, based in Menlo Park,
California, is a non-profit, independent national health care
philanthropy and is not associated with Kaiser Permanente or
Kaiser Industries.
The Agency for Health Care Policy and Research (AHCPR) is
the Federal focal point for health services research to improve
the quality of health care, reduce costs, and broaden access to
essential services.
Downloading Information
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Current as of December 2000
Internet Citation:
Americans as Health Care Consumers: The Role of Quality Information. Highlights of a National Survey. Kaiser Family Foundation, and the Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/kffhigh.htm