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Better use of quality-of-care ratings can lead to greater consumer control

Published on September 11, 2009 at 12:39 AM · No Comments

Knowing what numbers mean can lead to more informed choices, especially among people with lower math skills

A hospital pneumonia survival rate of 93 percent may sound good, but knowing that it's actually merely "fair" can help people pick a better hospital, according to new research. A "good" survival rate would be from 95 percent to 98 percent, medical experts say.

Better use of quality-of-care ratings can lead to greater consumer control, more effective health-care choices, and provider competition over quality instead of cost, says a report published by the American Psychological Association.

The findings are timely, given the ongoing debate over health-care and health-insurance reform. Providers and the media are showering decision-makers with raw numbers about everything from those pneumonia survival rates to the percentage of heart attack patients given key drugs and post-stay patient ratings. Typical measurements describe hospitals, nursing homes, doctors, treatments and health-insurance plans.

When it's hard to interpret the numbers, people are tempted to choose based on cost, such as monthly premiums, or even how they feel at the moment, said a report on the research, which was published in the September issue of the Journal of Experimental Psychology: Applied.

In four different studies, researchers asked people to pick fictional hospitals and health-insurance plans based on cost and quality-of-care data. Across the studies, getting the numbers in context strongly influenced decisions. People took quality data into account to a significantly greater degree when they were shown how the experts would rate the information.

When participants saw quality ratings expressed in context, in ranges such as "good," "fair" and "poor," they weighed quality more and cost less than participants who saw the same numbers out of context, the researchers found. For example, when choosing health-insurance plans, 54 percent of participants chose a higher-quality plan when given its numbers in context, while 39 percent chose it when given numbers out of context. Similarly, among older adults, 54 percent chose higher-quality plans when the numbers were evaluated; only 35 percent chose them when the numbers were without context.

Participants shown how to evaluate health-care data also leaned less on their momentary moods, which had nothing to do with quality measures.

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