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Consumers need help in understanding health care report
Although consumers are very interested in having access to
quality-of-care information about health plans, physicians, and
hospitals, many of them do not understand some of the indicators
appearing in health care report cards, according to the findings
of a project supported by the Agency for Health Care Policy and
Consumers are unsure what some of the quality indicators mean and
are more apt to rely on patient ratings of quality than objective
(clinically based) measures of quality. Moreover, many
individuals do not understand how managed care plans can affect
quality of care. For health care report cards to be useful,
consumers need to be educated about the meaning of quality
indicators and how health plans influence quality of care. These
indicators should be accompanied by explanations on the report
cards, explain Judith H. Hibbard, Dr.P.H., and Jacquelyn Jewett,
Ph.D., of the Oregon Research Institute.
They conducted 15 focus groups (104 participants) and surveyed
privately insured, publicly insured, and uninsured individuals to
explore consumer understanding of health care quality indicators.
The focus groups showed that consumers had little understanding
about the meaning of some quality indicators, for example, that
high rates of hospitalization for pediatric asthma represent poor
patient management and low birthweight babies often represent
poor prenatal care. Many also did not understand that plans can
influence how many members have mammograms or other preventive
screening tests. Uninsured and Medicaid beneficiaries tended to
have lower understanding than privately insured persons.
Understanding the health plan's role in influencing quality of
care and affecting the health of its enrolled populations are
important concepts for consumers. Indeed, they underlie the whole
rationale for report cards, according to the researchers. Plan
performance measures are designed to show how well a system is
caring for and maintaining the health of a defined population as
opposed to individual plan members. This population-based
definition of quality is a foreign concept to consumers whose
experience has been largely with fee-for-service care, conclude
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