Study: Many Consumers Remain Skeptical About Evidence-Based Care
Many consumers' attitudes appear to be at odds with the principles of evidence-based medicine, which stresses that more care does not necessarily represent better care, according to a study published Thursday in the journal Health Affairs, the Wall Street Journal's "Health Blog" reports (Hobson, "Health Blog," Wall Street Journal, 6/3).
For the study, researchers used an online survey, focus groups and one-on-one interviews to gather consumer opinions from more than 1,500 consumers with employer-provided insurance between 2006 and 2007.
The American Institutes for Research conducted the study with support from the California HealthCare Foundation and the National Business Group on Health (American Institutes for Research release, 6/3). CHCF is the publisher of California Healthline.
Study Findings
Researchers found that most consumers could not accurately define terms such as "quality guidelines," "quality standards" and "medical evidence."
The study noted that many respondents were skeptical of medical guidelines because they believed the guidelines would restrict physicians' ability to provide the best available and customized care. Researchers also found that respondents generally were more inclined to trust their own and their physician's assessments of quality ("Health Blog," Wall Street Journal, 6/3).
In addition, many respondents said they believe that:
- More treatment represents superior care;
- Newer treatments represent improved treatments; and
- More costly care represents more effective care.
Researchers noted that most respondents assume their physicians base care decisions on medical evidence. However, only 34% of respondents said they had discussed scientific research with their physician.
Among online survey participants, 55% said they had never taken notes during a medical appointment and 28% said they had never brought a question to ask their physician (American Institutes for Research release, 6/3).
Implications
According to the study authors, consumer perceptions that more care represents better care could hinder efforts to rework the health care provider payment system to offer rewards based on health care quality.
The authors write that if consumers believe "that all medical care meets minimum standards and that more care is better, differentiating among physicians, hospitals or other providers based on quality and efficiency profiles is likely to meet with resistance."
Toolkit
While conducting the study, the authors developed a communication toolkit designed to help employers and unions explain the concepts of evidence-based health care to their workers. The toolkit is available on the NBGH website (Rovner, "Shots," NPR, 6/3).
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