Christianson Jon, Maeng Daniel, Abraham Jean, Scanlon Dennis P, Alexander Jeffrey, Mittler Jessica, Finch Michael
University of Minnesota School of Public Health-Division of Health Policy and Management.
Geisinger Health System-Center for Health Research.
Medicare Medicaid Res Rev. 2014 Jun 9;4(2). doi: 10.5600/mmrr.004.02.a02. eCollection 2014.
Examine the factors that are associated with awareness of physician quality information (PQI) among older people with one or more chronic illnesses and the implications for Medicare.
DATA SOURCES/STUDY SETTING: Random digit-dial survey of adults with one or more chronic illnesses.
Structural equation modeling to examine factors related to awareness of PQI.
Awareness of PQI is low (13 percent), but comparable to findings in general population surveys. Age, race, education, and self-reported health status are associated with PQI awareness. Trust in the Internet as a source of health care information and not trusting one's physician as a source of information both are associated with a greater likelihood of being aware of PQI. Patients with high levels of activation have greater trust in physicians as information sources, but this is not associated with awareness, nor is degree of satisfaction with their care experience.
Awareness of PQI among older persons with chronic illnesses is relatively low across all socio-economic and demographic subgroups. Changes in population characteristics over time are unlikely to improve awareness in this population, nor are changes in patient activation or satisfaction with care. Medicare would need a broad-based effort if it wishes to raise PQI awareness among Medicare beneficiaries in the near term. Before undertaking resource-intensive efforts to increase awareness, Medicare may want to consider what level of awareness actually is needed to accomplish the overall objective for PQI transparency, which is raising the quality of care received by beneficiaries. It may be that relatively low levels of awareness are sufficient.
研究患有一种或多种慢性病的老年人中与医生质量信息(PQI)知晓度相关的因素及其对医疗保险的影响。
数据来源/研究背景:对患有一种或多种慢性病的成年人进行随机数字拨号调查。
采用结构方程模型来研究与PQI知晓度相关的因素。
PQI知晓度较低(13%),但与一般人群调查结果相当。年龄、种族、教育程度和自我报告的健康状况与PQI知晓度相关。将互联网作为医疗保健信息来源的信任度以及不信任自己的医生作为信息来源,均与更高的PQI知晓可能性相关。积极性高的患者对医生作为信息来源的信任度更高,但这与知晓度无关,他们对护理体验的满意度程度也与知晓度无关。
在所有社会经济和人口亚组中,患有慢性病的老年人对PQI的知晓度相对较低。随着时间推移,人口特征的变化不太可能提高该人群的知晓度,患者积极性或对护理的满意度变化也不会提高知晓度。如果医疗保险希望在短期内提高医疗保险受益人中的PQI知晓度,就需要开展广泛的工作。在进行资源密集型的提高知晓度努力之前,医疗保险可能需要考虑实际需要何种知晓度水平才能实现PQI透明度的总体目标,即提高受益人接受的护理质量。可能相对较低的知晓度水平就足够了。