Abraham Jean, Feldman Roger, Carlin Caroline
Department of Healthcare Management, University of Minnesota, Minneapolis, MN 55455, USA.
Health Serv Res. 2004 Dec;39(6 Pt 1):1799-815. doi: 10.1111/j.1475-6773.2004.00319.x.
To analyze the factors associated with employee awareness of employer-disseminated quality information on providers.
Primary data were collected in 2002 on a stratified, random sample of 1,365 employees in 16 firms that are members of the Buyers Health Care Action Group (BHCAG) located in the Minneapolis-St. Paul region. An employer survey was also conducted to assess how employers communicated the quality information to employees.
In 2001, BHCAG sponsored two programs for reporting provider quality. We specify employee awareness of the quality information to depend on factors that influence the benefits and costs of search. Factors influencing the benefits include age, sex, provider satisfaction, health status, job tenure, and Twin Cities tenure. Factors influencing search costs include employee income, education, and employer communication strategies. We estimate the model using bivariate probit analysis.
Employee data were collected by phone survey.
Overall, the level of quality information awareness is low. However, employer communication strategies such as distributing booklets to all employees or making them available on request have a large effect on the probability of quality information awareness. Employee education and utilization of providers' services are also positively related to awareness.
This study is one of the first to investigate employee awareness of provider quality information. Given the direct implications for medical outcomes, one might anticipate higher rates of awareness regarding provider quality, relative to plan quality. However, we do not find empirical evidence to support this assertion.
分析与员工对雇主发布的医疗服务提供者质量信息的认知相关的因素。
2002年收集了位于明尼阿波利斯-圣保罗地区的16家公司(买家医疗保健行动组织(BHCAG)的成员)中1365名员工的分层随机样本的原始数据。还进行了一项雇主调查,以评估雇主如何向员工传达质量信息。
2001年,BHCAG发起了两个报告医疗服务提供者质量的项目。我们将员工对质量信息的认知设定为取决于影响搜索收益和成本的因素。影响收益的因素包括年龄、性别、对医疗服务提供者的满意度、健康状况、工作任期和在双子城的居住期限。影响搜索成本的因素包括员工收入、教育程度和雇主的沟通策略。我们使用双变量概率分析来估计模型。
通过电话调查收集员工数据。
总体而言,质量信息认知水平较低。然而,雇主的沟通策略,如向所有员工分发手册或应要求提供手册,对质量信息认知的概率有很大影响。员工教育程度和对医疗服务提供者服务的使用也与认知呈正相关。
本研究是最早调查员工对医疗服务提供者质量信息认知的研究之一。鉴于对医疗结果有直接影响,相对于计划质量,人们可能预期对医疗服务提供者质量的认知率会更高。然而,我们没有找到实证证据来支持这一断言。