Online Program

Engaging consumers in questions about health care quality, efficiency, and value through hospital compare: Formative research findings from consumer focus groups

Tuesday, November 5, 2013

Margaret Gerteis, PhD, Mathematica Policy Research, Cambridge, MA
Cicely Thomas, MSc, Mathematica Policy Research, Princeton, NJ
Sally Crelia, MPH, L&M Policy Research, Washington, DC
David Miranda, PhD, Center for Medicare/Division of Consumer Assessment and Plan Performance, Centers for Medicare & Medicaid Services, Baltimore, MD
Rachel Dolin, L&M Policy Research, Washington, DC
Myra Tanamor, MPP, L&M Policy Research, Washington, DC
Research Objective: Medicare's Compare consumer websites are increasingly used as vehicles for publicly reporting complex performance information for federal quality and value-based reform initiatives. Yet prior research, focused on presenting comparative performance measures to inform consumer choice, suggests that consumers lack a frame of reference for understanding technical information on quality and value. Organizing and presenting this information for lay audiences has therefore proved challenging. Using consumers' subjective perceptions to frame discussions of healthcare quality and value, this qualitative research explored the face validity of the Institute of Medicine's (IOM) aims for improvement and the National Quality Strategy's (NQS) quality domains as conceptual and organizational frameworks for engaging consumers and publicly reporting on Hospital Compare. Study Design: Inductive analysis of facilitated focus group discussions. Population Studied: Adult health care consumers (n=31) living in the Atlanta, GA metro area, mixed by race, gender, education, and prior hospital experience. Principal Findings: Consumers' subjective perceptions of quality, based on concrete phenomena they observe first-hand, identify factors associated with quality as defined by the IOM/NQS domains. Consumers understand measures reported on Hospital Compare as aggregate indicators of hospital quality when the information is presented in this context. Implications for Policy, Delivery, or Practice: Framing discourse around questions about health care quality and value, rather than consumer choice, creates the opportunity to develop a common language to engage consumers, using the IOM or NQS domains as a framework. The specificity of quality measures reported on Hospital Compare can enhance understanding of these quality domains.

Learning Areas:

Administer health education strategies, interventions and programs
Communication and informatics
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related education
Public health or related public policy

Learning Objectives:
Describe the Institute of Medicine and National Quality Strategy health care quality domains. Identify factors that consumers associate with healthcare quality and value, based on their subjective perceptions and experiences. Discuss opportunities for using publicly reported technical quality metrics to engage lay consumer audiences.

Keyword(s): Communication, Health Care Quality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: A senior researcher with over 30 years of experience in health services research, I have led numerous studies exploring consumers’ perspectives on health care quality. For the past ten years, I have conducted research for the Centers for Medicare & Medicaid Services on the presentation of quality information to lay audiences on the Medicare website. I was lead editor of Through the Patient’s Eyes, which won the American Nursing Association’s 1993 Book-of-the-Year award.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.