An ongoing survey of American consumers provides valuable insights for occupational health professionals, particularly regarding the perceived value of access to care and interest in wellness and prevention services. The findings are reported in the Spectrum Health Value Study, TM the first publicly available longitudinal study of its kind. The study’s sponsor, Spectrum, a Washington, D.C.-based health and science communications firm, released results from the first two waves of data collection in mid-May. One of the goals of the project is to educate policymakers about consumer expectations as part of healthcare reform discussions. “Health reformers cannot afford to overlook how everyday constituents, when faced with difficult trade-offs, place a relative value on health services and products as they would spend their own money,” said John J. Seng, president and CEO of Spectrum. “With this new information, a vital piece of the health reform debate falls into place.” Based on the assumption that they would be spending their own money, a representative sample of survey respondents overwhelmingly ranked access to physicians, hospital services, and emergency care as their three most-valued healthcare-related priorities. In terms of perceived excellence, surgical services, over-the-counter drugs, and dentistry were the most highly valued. The most frequently used products/services were prescription medications, over-the-counter drugs, and dentistry. Psychiatric care, vocational rehabilitation, mental retardation services, and substance abuse programs were ranked as the least valued. However, these services were utilized by a relatively small percentage of respondents in comparison to the most highly valued services.
Prevention and Wellness
Occupational health professionals may find it particularly interesting that preventive health services ranked ninth in importance, and wellness services ranked 14th out of the 27 products, programs, and services included in the survey. Wellness services ranked 15th, and preventive health services ranked 16th in terms of service excellence. Respondents indicated that while they value preventive health services, they do not use them on a consistent basis, and when they do use them, they often are not satisfied with the quality. “While respondents valued both and rated the quality as average or higher, the use of preventive and wellness services, on a regular basis, is decidedly low,” Catherine Morrison, a Spectrum researcher, says in a related paper on The Value and Use of Preventive and Wellness Health Services. “Just over one-tenth of respondents regularly used the services.” In her paper, she draws two conclusions:
1. A disconnect exists between the value and use of preventive and wellness services: respondents highly value the availability of such services but they use them at a much lower rate.
2. A disconnect exists between the focus of healthcare spending in the United States and the value of preventive and wellness services.
“Moving forward, policymakers must keep in mind what consumers value,” Ms. Morrison writes. “The disconnect between value and use of preventive and wellness services deserves special attention. Preventive and wellness behaviors are complex and involve ongoing decisions, unlike the immediate treatment of illness. The social determinants of health, including education, information, and lack of access to such services may play an important role in the uptake of prevention and wellness services.”
Other Study Highlights
The following are some additional
study highlights:
• 69 percent of respondents agreed that the cost of health care benefits and services are ultimately paid for by individuals who contribute in various ways.
• The number of persons with health insurance coverage dropped from 82 percent in January 2009 to 74 percent by April.
• The percentage of people using products and services listed on the survey on a regular basis fell between January and April.
• Despite the recent influenza A (H1N1) outbreak, respondents placed nominal value on emergency relief and preventive services.
• Despite an increasing national focus on the obesity epidemic, respondents neither value nor use nutrition services. When they are used, they are not considered very satisfactory.
Study Parameters
The online study is being conducted by New York-based Russell Research in conjunction with Spectrum. It requires respondents to assign “importance ratings” to 27 programs, services, and products designated by healthcare industry Standard Industrial Classification (SIC) codes. In general, SIC codes provide a list of all goods and services that are produced and measured as part of the U.S. economy. According to Spectrum, comparing the relative value of the 27 healthcare sector codes “is one way to quantify their value.” In the survey, sets of four products and services are randomly grouped, and respondents are asked to identify which item in each group they value most and which they value least when spending their own money. A maximum difference analysis is then used to compile the responses.
The survey features three basic questions:
Q: Recognizing that health care costs vary, depending on your level of insurance coverage and other health benefits that you either purchase or receive through an employer or other source, and thinking about the actual cost of dollars that are spent, listed below are four health care services with costs that you and other individuals may ultimately pay for either directly or indirectly. Of these four, which is the most important and which is the least important for you and your family as you spend your health care dollars?
Q: In general, how would you rate health care services that are available in the U.S.? For each of the following services, please use a scale of 1 to 10, where 10 means that in general that service is excellent and 1 means in general that service is poor.
Q: Which, if any, of the following healthcare services and programs do you use on a regular basis?
Recommended Resources
American College of Occupational and Environmental Medicine electronic “mini-guides” on fibromyalgia and the use of opioids in chronic pain cases; these new mini-guidelines are excerpted from ACOEM’s Occupational Medicine Practice Guidelines; www.acoem.org
Fundamentals of Office Ergonomics; 130-page soft cover book features excerpts from The Ergonomics ReportTM and Ergonomics TodayTM and includes chapters on productivity, quality, health and safety, the business case for ergonomics, risk factors, MSDs and computer use; www.ergobuyer.com
Low-Volume/No-Volume Practitioners: Best Practices for Competency, Privileging, and Strategy; free white paper from the Greeley Medical Staff Institute; www.greeley.com
NIDAMED, a National Institute on Drug Abuse Physicians’ Outreach Initiative, gives medical professionals tools and resources to screen patients for tobacco, alcohol, illicit and non-medical prescription drug use. The initiative stresses the importance of the patient-doctor relationship in identifying unhealthy behaviors before they evolve into life-threatening conditions; www.drugabuse.gov
NIOSH Blog; the National Institute for Occupational Safety and Health sponsors a web-based discussion group. One of the most recent topics was Using Digital Chest Images to Monitor the Health of Coal Miners and Other Workers; to participate, visit www.cdc.gov/niosh/blog/index.html
Use of a Closed System Device to Reduce Occupational Contamination and Exposure to Antineoplastic Drugs in the Hospital Work Environment; J Yoshida, et. al; Ann Occup Hyg, Vol. 53, p. 153-160, 2009; http://annhyg.oxfordjournals.org.
What factors predict full or partial return to work among sickness absentees with spinal pain participating in rehabilitation? Researchers find patients with long previous sick leave can increase working time after a multi-disciplinary rehabilitation program, especially if they are younger, have lower levels of activity limitations and pain, and have better social functioning; B Elfving, et. al.; Disabil Rehabil, March 17:1-10, 2009.
