Press Release

Embargoed Until Contact

June 03, 2010
12:01 AM EST

Kay Campbell
(301) 652-1558


Sue Ducat
Director of Communications
(301) 841-9962


New Study Explains Why Consumers Frequently Don't Embrace Evidence-Based Health Care


Bethesda, MD - Misconceptions and a lack of knowledge have caused many Americans with health insurance to be at odds with policy makers when it comes to embracing the tenets of evidence-based health care. This finding, documented by focus groups, interviews, and an online survey, was released today in a Web first article in Health Affairs.


Evidence That Consumers Are Skeptical About Evidence-Based Health Care
By Kristin L. Carman, Maureen Maurer, Jill Mathews Yegian, Pamela Dardess, Jeanne McGee, Mark Evers, and Karen O. Marlo


Carman, Maurer, and Dardess are affiliated with the American Institutes for Research, in Washington, D.C., and Chapel Hill, North Carolina; Yegian is with the California HealthCare Foundation, in Oakland, California; McGee and Evers are principals at McGee and Evers Consulting, in Vancouver, Washington; and Marlo is with the Institute on Health Care Costs and Solutions, National Business Group on Health, in Washington, D.C. Funding for this research was provided by the California HealthCare Foundation.


The study collected data between August 2006 and December 2007 and used a mixed-methods approach. Qualitative methods included four focus groups involving thirty-four consumers and one-on-one interviews with fifty-seven individuals. In addition, the authors conducted interviews with forty "employer intermediaries" who regularly communicate about health care--for example, human resource personnel and other experts. Quantitative methods included a related survey effort for which the research team asked questions about employee attitudes toward and experience with evidence-based health care. These questions were included in an online survey of more than 1,500 employees, commissioned by the National Business Group on Health in September 2007. Some of the convergent findings:


Consumers think that medical guidelines are inflexible. Many focus group participants said they preferred to

trust their own and their physicians' judgments about quality and thought that relying on clinical practice guidelines would be too rigid and take away their ability to choose. Said one participant: "This is just a way for doctors to say, 'I'm following the national guidelines, so you can't sue me if something goes wrong.'"


Consumers believe that more care and newer care is better. According to the online survey, only 47 percent of respondents agreed that it is reasonable to pay less out of pocket for the most effective treatments and drugs.


Consumers believe that more costly care is better. A sizeable number of survey participants (33 percent) agreed with the statement "medical treatments that work the best usually cost more than treatments that don't work as well." Only 27 percent of respondents disagreed, and 40 percent of respondents neither agreed nor disagreed.


Many consumers do not engage in behaviors that could help them become better medical decision makers. For example, 55 percent of respondents to the online survey said they never took notes during medical appointments, and 28 percent said they never prepared questions in advance to ask their doctors.


"Our study demonstrated that there are critical gaps in consumer knowledge that challenge ongoing efforts to encourage consumers to use evidence-based health care," said Dr. Carman. "However, our findings also indicate some cause for optimism: a small but significant minority of our respondents accepts the underlying concepts of evidence-based health care and wants to assume a more informed and active role in their health care decision-making."

About Health Affairs

Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears each month in print, with additional Web First papers published weekly at http://www.healthaffairs.org/. The full text of each Health Affairs Web First paper is available free of charge to all Web-site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund.