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消费者了解他们的健康保险计划是如何运作的吗?

Do consumers know how their health plan works?

作者信息

Cunningham P J, Denk C, Sinclair M

机构信息

Center for Studying Health System Change, Washington, D.C., USA.

出版信息

Health Aff (Millwood). 2001 Mar-Apr;20(2):159-66. doi: 10.1377/hlthaff.20.2.159.

DOI:10.1377/hlthaff.20.2.159
PMID:11260939
Abstract

Expanding consumer choice of plans is beneficial only to the extent that consumers make informed choices. Using data from the 1996-97 Community Tracking Study (CTS), this study compares consumers' responses on four key attributes of their health plan with information provided directly by the plan. Plan attributes relate to choice of providers and access to specialists. Although the accuracy of reporting some individual attributes was fairly high, fewer than one-third of consumers accurately reported all four health plan attributes. In general, consumers tended to overreport plan restrictions, especially the need for approval to see specialists.

摘要

扩大消费者对保险计划的选择只有在消费者做出明智选择的情况下才有益。本研究使用1996 - 1997年社区追踪研究(CTS)的数据,将消费者对其健康保险计划四个关键属性的反馈与该计划直接提供的信息进行比较。计划属性涉及提供者的选择和专科医生的就诊机会。虽然报告某些个别属性的准确性相当高,但准确报告所有四个健康保险计划属性的消费者不到三分之一。总体而言,消费者倾向于高估计划限制,尤其是看专科医生需要获批这一限制。

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