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Presentation on Chronic Illness and how Americans\' Value Health Care products, programs and services www.healthvaluestudy.com
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The Spectrum Health Value Study™
Presentation to the Chronic Care & Prevention CongressMay 19, 2009
Introductory Remarks
“To address both the costs and performance of the health care system, greater consensus will be required on what constitutes value in health care, and how to measure and increase that value.”
Institute of MedicineRoundtable on Evidence Based Medicine, March 2009
The purpose of this study is to identify the relative level of importance of health programs, product and services.
Specifically, the research objectives were designed to:
1. Gain a better understanding of consumer use of and relationship to health programs, products and services
2. Evaluate the relative value consumers place on different attributes of health programs, products and services
3. Identify key segments of health care consumers such as those with chronic illness
Purpose and Objectives
3
A total of 1,013 respondents in January and 1,012 respondents inApril were interviewed for this study for a total of 2,025respondents to date.
1235 Respondents indicated that they suffered from a chronic illness in the past year
790 Respondents did not suffer from any chronic illness in the past year
Respondents were matched to the US population by: AgeGenderCensus RegionEthnicity
Methodology
4
Health Care Benefits,Attitudes And Usage
The Chronically Ill by Age; between ages 35 and 54 there are no statistically significant differences in the numbers; however at younger ages, people are more well and at older ages people are chronically ill.
The Chronically Ill and Non-Sufferers by Age
5
8 87
8
1312
3
2
99
1212
9
6
4
2 1
8
11
16
11
15
10
-
2
4
6
8
10
12
14
16
18
18-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75 or older
Sufferers Non-Sufferers
The majority of all respondents currently have health insurance. The percentage of all respondents covered dropped significantly from January to April, there was also change in coverage for persons who reported suffering from chronic illness from 82% in the first quarter to 77 in the second quarter
7Q7. Do you currently have health insurance?Base = Total Respondents
78 7782
0
10
20
30
40
50
60
70
80
90
100
Total (n=2025) Q. 1 Sufferers (n=1235) Q. 2 Sufferers (n=790)
The number of covered person who believe that insurance coverage is ‘Absolutely essential’ is about 68%. Among those who suffer from chronic illness, the number is much higher and is contrasted here with those persons who do not have chronic illness. (Data are for both quarters)
6861
72
0
10
20
30
40
50
60
70
80
90
100
Total (n=2025) Total Sufferer (n=1235) Total Non Sufferer (n=790)
8 Q7. How important do you think it is to have health insurance?
Base = Total Respondents
9
Sufferers seem to have lost some ground, in terms of their coverage over the past three months in terms of what they say is covered by their plans. It should be noted that because this groups uses their coverage more frequently, they are more sensitive to changes in their coverage, than for example, the total respondent group.
Base = Total Have Health Insurance
Q11. Which of the following are covered by your current health insurance plan?
9288 88 85
51 52 54
37
1
9388 86 84 83 84
76
55 55 52
39
2
9288 88
8288
-
20
40
60
80
100
Doctor visits Hospitalstays
Emergencyroom visits
Prescriptions Annualexams/
Preventivecare
Lab tests Outpatientprocedures
MajorMedical
Dental Vision Mentalhealth and/
or substanceabuse
Hearing All othermentions
Q1 Sufferers(n=520) Q2 Sufferers (n=483)
Q2Q2 Q2
Q2
Overall Ratings ofHealth Care ServicesAnd Programs
Generally, when asking respondents how satisfied they are with service, programs and products they have actually used, non-sufferers tend to give higher satisfaction scores than do sufferers. However, on a few items—which may be considered specialty concerns—the opposite is true with sufferers having greater satisfaction with surgical services, medical and scientific research and emergency care.
Q1. In general, how would you rate health care services that are available in the U.S.? For each of the followingservices please use a scale of 1 to 10, where a 10 means that in general that service is EXCELLENT and a 1 means that ingeneral that service is POOR.
Base = Total Respondents
49
51
57
58
60
61
70
45
46
39
36
54
41
72
55
55
69
58
63
70
65
69
72
74
68
0 10 20 30 40 50 60 70 80 90 100
Emergency Care Services
Scientific Research
Medical ResearchPharmaceutical Research
Medical Services At A Hospital
Outpatient Services
Surgical Services
Health/Personal Care Goods
Prescription Drugs
Over The Counter DrugsDiagnostic Laboratory Services
Dentist Services
Physician Services
Non-Sufferers
Sufferers
11
ns
Services Used On A Regular Basis
Chronically ill people use statistically significantly more drugs, both prescription and OTC, than their uninsured counterparts on a regular basis. They also use more of other health care services and programs on a regular basis. There is no program, product or service that is more used on a regular basis by non-sufferers than by those with chronic illness.
Q3. Which, if any, of the following health care servicesand programs do you use on a regular basis?
Base = Total Respondents
6
6
1
3
4
6
5
9
8
8
6
14
39
30
41
35
3
5
11
18
23
12
14
20
46
55
61
71
0 10 20 30 40 50 60 70 80
Surgical Services
Emergency Care Services
Nutrition Services
Family Social/Health Services
Medical Services At A Hospital
Wellness Services
Preventive Health Services
Diagnostic Laboratory Services
Outpatient Services
Health/Personal Care Goods
Dentist Services
Physician Services
Over The Counter Drugs
Prescription Drugs
Sufferers Non-Sufferers
13
5
10
11
14
16
43
5
4
4
4
9
11
12
13
17
7
7
8
8
14
40
49
53
23
47
48
58
61
- 10 20 30 40 50 60 70 80
Individual social/health services
Psychiatric services
Mental health services
Family social/health services
Medical services at a hospital
Wellness services
Preventive Health Services
Outpatient services
Diagnostic laboratory services
Health/personal care goods
Dentist services
Physician services
Over the counter drugs
Prescription drugs
Total Q2 (n=1012) Total Q1 (n=1013)
14
Base = Total Respondents
Q3. Which, if any, of the following health care services and programs do you use on a regular basis?
When we look at all respondents, the percent of people using products and services on a regular basis has generally fallen between January 2009 and April 2009.
Q2
Q2
Q2
Q2
Q2
Q1
Q1
Q1
15
Base = Total Respondents
Q3. Which, if any, of the following health care services and programs do you use on a regular basis?
When we look at just respondents who reported having a chronic illness (n=1235), the use of some products have increased and others have decreased between January 2009 and April 2009. Question: Are the services in the red circle more, economically, elastic than the other services?
1 1 4 4 4 6
27
50
6067
76
3 38 8 9 10
18
42
5156
66
-
10
20
30
40
50
60
70
80
90
100
Pharm
aceut
ical r
esea
rch
Vocat
iona
l reh
abilita
tion
Psych
iatri
c ser
vices
Men
tal h
ealth
ser
vices
Family
soc
ial/h
ealth
serv
ices
None
of the
Abo
ve
Health
/per
sonal
care
goo
ds
Dentis
t ser
vices
Physic
ian
serv
ices
Ove
r the
cou
nter
dru
gs
Presc
riptio
n dr
ugs
January April 09
Max-Diff
Max-Diff was chosen over other techniques because:
1. It is easy to administer to respondents
2. 2. It is easy to implement and to analyze
3. 3. And, it provides extremely discriminating data
Max-Diff
17
The three most important health care services have to do with “access”: physician services, medical services at a hospital and emergency care services, prescription drugs are not far behind.
Q5. Recognizing that health care costs vary, depending on your level of insurance coverage and other health benefits that you either purchaseor receive through an employer or other source, and thinking about the actual dollars that are spent, listed below are four health care serviceswith costs that you and other individuals ultimately pay for either directly or indirectly. Of these four, which is the most important and which isthe least important for you and your family as you spend your health care dollars.
Base = Total Respondents
51
52
60
60
69
71
75
75
81
87
90
91
95
54
49
57
53
64
6866
71
72
83
89
89
91
0 20 40 60 80 100
Health/personal Care Goods
Wellness Services
Medical Research
Over The Counter Drugs
Preventive Health Services
Surgical Services
Diagnostic Laboratory Services
Outpatient Services
Dentist Services
Prescription Drugs
Emergency Care Services
Medical Services At A Hospital
Physician Services
Total Apr Total Jan
M
F
F
F
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q1
18
Between January and April, some products and services seemed to gain ground such as family social/health services.
The least valued services did not change.
Q5. Recognizing that health care costs vary, depending on your level of insurance coverage and other health benefits that you either purchaseor receive through an employer or other source, and thinking about the actual dollars that are spent, listed below are four health care serviceswith costs that you and other individuals ultimately pay for either directly or indirectly. Of these four, which is the most important and which isthe least important for you and your family as you spend your health care dollars.
Base = Total Respondents
6
6
12
15
19
26
27
2936
43
44
44
45
50
11
9
15
21
25
32
29
33
39
50
40
43
47
51
0 20 40 60
Substance Abuse Services
Mental Retardation Services
Vocational Rehabilitation
Psychiatric Services
Mental Health Services
Health Relief Services (such As …
Nutrition Services
Home Health Services
Nursing Care Services
Family Social/health Services
Scientific Research
Pharmaceutical Research
Care For The Elderly
Individual Social/health Services
Total Apr Total Jan
Any ratings lower than 50 mean those features lost
out to another feature more than half the
time
Q1
Q1
Q1
Q1
Q1
19
For the top five ‘access’ services, only emergency care services did not differ significantly between the chronically ill and non-sufferers. Interestingly, non-sufferers value medical research significantly more than do the chronically ill.
Q5. Recognizing that health care costs vary, depending on your level of insurance coverage and other health benefits that you either purchaseor receive through an employer or other source, and thinking about the actual dollars that are spent, listed below are four health care serviceswith costs that you and other individuals ultimately pay for either directly or indirectly. Of these four, which is the most important and which isthe least important for you and your family as you spend your health care dollars.
Base = Total Respondents
56
73
52
58
66
67
79
79
89
91
72
75
87
90
90
71
66
57
49
50
9489
69
67
60
57
0 20 40 60 80 100
Health/personal Care Goods
Wellness Services
Medical Research
Over The Counter Drugs
Preventive Health Services
Surgical Services
Diagnostic Laboratory Services
Outpatient Services
Dentist Services
Prescription Drugs
Emergency Care Services
Medical Services At A Hospital
Physician Services
Sufferers Non-Sufferers
M
F
F
F
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q1
20
Non-sufferers value both individual social/health services and family social/health services more than do persons with chronic illness. They also value health relief services more. The chronically ill value Care for the Elderly much more than do person who do not suffer from a chronic illness.
Q5. Recognizing that health care costs vary, depending on your level of insurance coverage and other health benefits that you either purchaseor receive through an employer or other source, and thinking about the actual dollars that are spent, listed below are four health care serviceswith costs that you and other individuals ultimately pay for either directly or indirectly. Of these four, which is the most important and which isthe least important for you and your family as you spend your health care dollars.
Base = Total Respondents
8
32
46
43
50
8
15
39
4249
40
36
27
29
23
19
14
8
53
44
44
50
33
32
32
21
18
9
0 20 40 60
Substance Abuse Services
Mental Retardation Services
Vocational Rehabilitation
Psychiatric Services
Mental Health Services
Health Relief Services
Nutrition Services
Home Health Services
Nursing Care Services
Family Social/health Services
Scientific Research
Pharmaceutical Research
Care For The Elderly
Individual Social/health Services
Sufferers Non-sufferers
Any ratings lower than 50 mean those features lost
out to another feature more than half the
time
Q1
21
• To view our complete information on the Spectrum Health Value Study, including methodology and additional findings go to: www.healthvaluestudy.com
• We are continuing quarterly data collection, with the next collection in July 2009 and the next release of data and reports in August.
• For more information contact Audrey Spolarich at 202-587-2532 or [email protected]
Thank You.
22
