Hibbard Judith H, Greene Jessica, Tusler Martin
Department of Planning, Public Policy, and Management, University of Oregon, 119 Hendricks Hall, Eugene, OR 97403-1209, USA.
Am J Manag Care. 2008 Nov;14(11):729-36.
Underlying consumer-driven health plans (CDHPs) is the belief that the financial incentives, enhanced choices, and increased information will stimulate consumers to become active, informed managers of their own health and healthcare (ie, activated consumers). To examine this assumption, we assessed whether enrollees became more activated after enrolling in a CDHP and the degree to which those who were more activated adopted productive health behaviors.
This was a longitudinal study of employees of a large manufacturing company where a CDHP was offered along with a preferred provider organization in 2004. Two waves of survey data were collected with a final sample size of 1616 employees.
The hypothesis that enrollees in a CDHP become more activated over time was not supported. However, the data suggest that those who were more activated were more likely to engage in the behaviors that CDHPs seek to encourage and to newly adopt these behaviors over time. This appeared to be true regardless of plan type.
Even though CDHPs do not appear to foster activation, they may provide a supportive environment for those who are more activated to manage their health. Encouraging enrollment based on enrollee readiness to take advantage of the CDHP environment may be more productive than relying on plan designs alone to activate enrollees once they are enrolled.
消费者驱动型健康计划（CDHPs）的潜在理念是，经济激励、更多选择和更多信息将促使消费者成为自身健康及医疗保健的积极、明智管理者（即活跃消费者）。为检验这一假设，我们评估了参保CDHP后参保者是否变得更加活跃，以及那些更活跃的参保者采取有益健康行为的程度。
这是一项针对一家大型制造公司员工的纵向研究，该公司于2004年推出了CDHP以及优选医疗机构组织。收集了两波调查数据，最终样本量为1616名员工。
CDHP参保者随着时间推移会变得更加活跃这一假设未得到支持。然而，数据表明，那些更活跃的人更有可能参与CDHPs旨在鼓励的行为，并随着时间推移新采取这些行为。无论计划类型如何，情况似乎都是如此。
尽管CDHPs似乎并未促进活跃度，但它们可能为那些更活跃的人管理自身健康提供一个支持性环境。基于参保者利用CDHP环境的准备程度鼓励参保，可能比仅依靠计划设计在参保后激活参保者更有成效。
