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2012 Potpourri XX

By June 15, 2012Commentary

The firm of Peppers & Rogers released a study on Consumer Trust in Healthcare.  In general, the survey classified about 43% of the population as distrusters, 38% as trusters and 19% as neutral in regard to their health insurer.  Kaiser has higher levels of trust than the four large commercial health plans.  People who distrust their health insurer tend to be more trusting of physicians whereas people who trust the insurer have about equal levels of trust for providers.  As might be expected, trusters have a stronger attachment to their insurer and are less likely to switch and more likely to recommend the plan to others.  The obvious steps to improve trust include treating the consumer as an individual, being sensitive to his or her issues and being open and honest in issues. (P&R Report)

Wolters Kluwer also did a survey relating to trust, this time in regard to online health information.  The survey found that many Americans, about 30%, frequently go online for health information and about 65% say they generally trust what they find.  About 67% say the data they find online makes them better patients, with half saying that they seek the information so that they are more informed and better prepared for a physician visit.  Consumers often use the online data to diagnose themselves, and claim to rarely make a mistake, although they almost always discuss their perceptions with a physician.   (Wolters Survey)

Thomson also has a survey out, this one looking at price transparency in health care.  About 80% of households surveyed said they had received some kind of health care service in the past year and about 16% said they sought pricing information before the service, up from about 11% the year before.  Around 50% of people got the data from the physician’s office and 49% received it from their insurer.  About 45% of the respondents used the internet to access the data.  About 86% of respondents found the data to be accurate, down from 98% in 2010.  While there is some difference across income and education groups, all are pretty heavy obtainers of this data.   (Thomson Survey)

There has been significant concern about not just the cost impacts but the patient safety risk of excessive imaging.  Much of the inappropriate use is blamed on the fee-for-service system.  A study reported in the Journal of the American Medical Association examined imaging rates over 15 years in several large integrated provider/payer systems, such as Kaiser.  Even in these systems, there was very rapid growth in imaging rates.  Over the 15 years, CT use almost tripled, MRI use almost quadrupled, ultrasound doubled and PET use expanded even further.  The proportion of patients who received high radiation doses also increased significantly.  It would appear that many physicians feel there is a clinical justification for more imaging even when they don’t get a financial benefit.   (JAMA Article)

Another study reported in the Journal of the American Medical Association compared telephonic and face-to-face behavioral therapy among primary care depression patients.  Depression is a common and hard to treat condition which can affect general health.  Severely depressed patients often have difficulty keeping appointments.  In this randomized trial, some patients were treated by phone instead of in-person, using the same treatment protocol.  The primary outcome was therapy adherence, with a secondary measure of depression severity.  Generally, in the telephonic arm, there was less therapy dropout and more overall session attendance.  The telephonic arm was equivalent in impact on depression severity.     (JAMA Article)

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