Cancer patients' and families' perceptions of nurse caring behaviors.
Explore the source record for details and available documents.
Clinical Competence↗
SEARCH · PubMed Health
Results for “Consumer Behavior”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Measuring consumer perceptions of quality differences among competing health benefit plans.
In this paper, we combine revealed preference and survey data on attribute importance to estimate parameters that represent average perceived differences in the quality and convenience of competing health benefit plans. We find that consumers do not perceive differences in provider quality across options. though they do perceive differences related to waiting time and access to specialists. In order to validate our approach, we estimate parameters representing perceived premiums and compare the estimates to actual premium differences. The results suggest that consumers correctly perceive the high-premium option to cost more than the low-premium option. These results increase our confidence in the use of stated importance data to identify and interpret parameters measuring the effect of otherwise unobservable attributes of choice alternatives.
Choice Behavior↗
Early experience with employee choice of consumer-directed health plans and satisfaction with enrollment.
OBJECTIVE: To assess the initial impact of offering consumer-defined health plan (CDHP) options on employees. DATA SOURCES/STUDY SETTING: A mail survey of 4,680 employees in the corporate offices of Humana Inc. in June 2001. STUDY DESIGN: The study was a cross-sectional mail survey of employees aged 18 and older who were eligible for health care benefits. The survey was conducted following open enrollment. The primary outcome is the choice of consumer-directed health plan or not; the secondary outcome is satisfaction with the enrollment process. Important covariates include sociodemographic characteristics (age, gender, race, educational level, exempt or nonexempt status, type of coverage), health status, health care utilization, and plan design preferences. DATA COLLECTION METHODS: A six-page questionnaire was mailed to the home of each employee, followed by a reminder postcard and two subsequent mailings to nonrespondents. PRINCIPAL FINDINGS: The response rate was 66.2 percent. Seven percent selected one of the two new plan options. Because there were no meaningful differences between employees choosing either of the two new options, these groups were combined in multivariate analysis. A logistic regression modeled the likelihood of choosing the novel plan options. Those selecting the new plans were less likely to be black (odds ratio [OR] 0.46), less likely to have only Humana coverage (OR 0.30), and more likely to have single coverage (OR 1.77). They were less likely to have a chronic health problem (OR 0.56) and more likely to have had no recent medical visits (OR 3.21). They were more likely to believe that lowest premiums were the most important plan attribute (OR 2.89) and to think there were big differences in the premiums of available plans (OR 5.19). Employees in fair or poor health were more likely to have a difficult time during the online enrollment process. They were more likely to find the communications very helpful (OR 0.42) and the benefits information very understandable (OR 0.38). They were less likely to feel that they had enough time to make their enrollment decision (OR 0.47). CONCLUSIONS: Employees who were attracted to the new CDHP plan options valued the attributes that distinguished these plans from other choices. The shift to consumer-defined plans and to the electronic provision of information, however, requires a significant increase in the communication support for all employees, but particularly for those in fair or poor health whose information needs are the most complex and individualized.
Adult↗
Elaborating a dichtomous measure of enrollment choice: HMOs vs FFS plans.
The objective of this study is to make health insurance plans more responsive to the needs of people by identifying plan characteristics that are important to consumers during their enrollment decisions. Employees from three companies were surveyed. Factor analysis indicated four dimensions of plans that are important to consumers: cost, freedom, quality, and psychosocial access. Among characteristics that described the "cost dimension" of plans, unpredictable out-of-pocket costs was the most important. Among characteristics that described the "freedom" dimension of plans, freedom to go to any doctor without authorization from the primary care physician was most important.
Choice Behavior↗
Consumer behaviour and attitudes towards low-calorie products in Europe.
A number of observations and conclusions can be made based on the data we have just seen: (1) There are large differences across the countries in terms of penetration of 'light' products. (2) The penetration of low-fat products is higher than that of low-sugar products. (3) Penetration of both low fat and low sugar products is higher among women than among men. (4) Penetration of both low-fat and low-sugar products is not dependent on age. (5) Consumption relates to penetration. (6) Consumer concerns about fat are greater than about sugar. (7) Consumer concerns about fat are at approximately the same level across Europe. (8) Concern about fat and sugar seems to increase with age. (9) Overweight is a problem for a third of the population across Europe. (10) Overweight is higher among men than among women. (11) Overweight increases with age.
Adolescent↗
Providing information to help Medicare beneficiaries choose a health plan.
Many Medicare beneficiaries have limited knowledge of the Medicare program and related health insurance options. This is due in part to the complexity of the Medicare program and supplemental health insurance market. A recent congressional mandate through the Balanced Budget Act of 1997 called for broad dissemination of information to educate beneficiaries about their health plan options and to encourage informed health plan decision-making. In response, the Health Care Financing Administration (HCFA) launched the National Medicare Education Program (NMEP) to support the educational objectives of the BBA. This paper provides an overview of the components of the NMEP information campaign. We also review lessons learned from our experience in designing and testing a prototype consumer handbook that explains the different health plan options to Medicare beneficiaries. Through our discussion of the handbook, we highlight several ways to communicate information effectively about a complex publicly funded program to an older adult population.
Aged↗
Consumer mobility in social health insurance markets : a five-country comparison.
During the 1990s, the social health insurance schemes of Germany, the Netherlands, Switzerland, Belgium and Israel were significantly reformed by the introduction of freedom of choice (open enrolment) of health insurer. This was introduced alongside a system of risk adjustment to compensate health insurers for enrolees with predictable high medical expenses. Despite the similarity in the health insurance reforms in these countries, we find that both the rationale behind these reforms and their impact on consumer choice vary widely.In this article we seek to explain the observed variation in switching rates by cross-country comparison of the potential determinants of health insurer choice. We conclude that differences in choice setting, and in the net benefits of switching, offer a plausible explanation for the large differences in consumer mobility.Finally, we discuss the policy implications of our cross-country comparison. We argue that the optimal switching rate crucially depends on the goals of the reforms and the quality of the risk-adjustment system. In view of this, we conclude that switching rates are currently too low in the Netherlands, and an active government policy to encourage consumer mobility seems warranted. In Germany and Switzerland, high switching rates call for an improvement of the rather poor risk-adjustment systems. Given low switching rates in Israel and Belgium, improving risk adjustment is less urgent, but still required in the long run.
Belgium↗
Do consumer reports of health plan quality affect health plan selection?
OBJECTIVE: To learn whether consumer reports of health plan quality can affect health plan selection. DATA SOURCES: A sample of 311 privately insured adults from Los Angeles County. STUDY DESIGN: The design was a fractional factorial experiment. Consumers reviewed materials on four hypothetical health plans and selected one. The health plans varied as to cost, coverage, type of plan, ability to keep one's doctor, and quality, as measured by the Consumer Assessment of Health Plans Study (CAHPS) survey. DATA ANALYSIS: We used multinomial logistic regression to model each consumer's choice among health plans. PRINCIPAL FINDINGS: In the absence of CAHPS information, 86 percent of consumers preferred plans that covered more services, even though they cost more. When CAHPS information was provided, consumers shifted to less expensive plans covering fewer services if CAHPS ratings identified those plans as higher quality (59 percent of consumers preferred plans covering more services). Consumer choices were unaffected when CAHPS ratings identified the more expensive plans covering more services as higher quality (89 percent of consumers preferred plans covering more services). CONCLUSIONS: This study establishes that, under certain realistic conditions, CAHPS ratings could affect consumer selection of health plans and ultimately contain costs. Other studies are needed to learn how to enhance exposure and use of CAHPS information in the real world as well as to identify other conditions in which CAHPS ratings could make a difference.
Adolescent↗
A consumer-based tool for evaluating the quality of health services in the Israeli health care system following reform.
Many countries have reformed their health care systems in the past decade and, as such, the need to monitor health system performance is widely recognized. In this paper we present a method for constructing quality indicators, which were used to evaluate the reformed Israeli health care system, and demonstrate the sensitivity of these indicators to change over time and to differences in quality among health plans and among population groups. The quality indicators were developed based on consumers' reports of their experiences in the health system. The indicators were measured in periodic population telephone surveys conducted between August and October of 1995, 1997, and 1999, using a structured questionnaire in Hebrew, Arabic, or Russian, this ensured the inclusion of all major sub-groups of Israel's population. Between 1080 and 1749 people were interviewed, with a response rate of over 80% each year. Using the theory-based evaluation approach, we specified the plausible causal links among intervention (components of the National Health Insurance Law), intermediate outputs (changes in health plan organizational behavior), and consumer outcomes. This led to the identification of indicators of quality of ambulatory health services, which included measures of accessibility, availability, patient satisfaction, performance of preventive medicine, and utilization of private medical services. The consumer-based evaluation tool presented in this paper was found to be easy to apply, sensitive, and relatively inexpensive. We hope that our approach will be of use to other countries that want to evaluate system-wide change and monitor quality of services over time.
Ambulatory Care↗
Hospital choice factors: a case study in Turkey.
In an attempt to test the robustness of the numerous American findings related to hospital choice in the context of another country, this study examines the factors affecting hospital choice decisions of 869 patients in three public and one private hospital policlinics in Ankara, Turkey and attempts to determine their importance levels. Identification of these factors and determining their effect levels is important in concentrating management efforts on these key areas and in formulating effective marketing strategies to retain and expand hospital patient bases in the future. Our findings highlight the importance of accessibility of hospital services to consumers in hospital choice as well as the role of hospital's image, its physical appearance, and technological capabilities in informing such choices. American health care managers can use these findings to further understand how patients make choices related to health care facilities and to develop marketing strategies that may more effectively market their facilities.
Adult↗
Uninformed choice.
The United Kingdom recently reformed its health service to promote consumer choice of a provider. The authors investigate the evaluative strategies patients use for their present primary care provider as a precursor to determining future choice criteria. However, this information has only limited value since health care providers still cannot market their services. The policy changes have introduced structural reforms but are not addressing some of the practical constraints to choice in this market.
Choice Behavior↗
Choosing a health plan: what information will consumers use?
Employers and policymakers are looking for ways to encourage competition among health plans, thus lowering costs and improving quality. Employers hope to foster competition among health plans by creating standardized measures of quality that supplement the traditional benefits and cost information employees use to compare plans and make choices. This DataWatch examines employees' interest in standardized measures of plan performance. Results from a survey of Massachusetts state employees show that cost and benefit information receive high rankings, but certain plan performance information does not.
Adult↗
Breaking the trade-off between efficiency and service.
For manufacturers, customers are the open wallets at the end of the supply chain. But for most service businesses, they are key inputs to the production process. Customers introduce tremendous variability to that process, but they also complain about any lack of consistency and don't care about the company's profit agenda. Managing customer-introduced variability, the author argues, is a central challenge for service companies. The first step is to diagnose which type of variability is causing mischief: Customers may arrive at different times, request different kinds of service, possess different capabilities, make varying degrees of effort, and have different personal preferences. Should companies accommodate variability or reduce it? Accommodation often involves asking employees to compensate for the variations among customers--a potentially costly solution. Reduction often means offering a limited menu of options, which may drive customers away. Some companies have learned to deal with customer-introduced variability without damaging either their operating environments or customers' service experiences. Starbucks, for example, handles capability variability among its customers by teaching them the correct ordering protocol. Dell deals with arrival and request variability in its high-end server business by outsourcing customer service while staying in close touch with customers to discuss their needs and assess their experiences with third-party providers. The effective management of variability often requires a company to influence customers' behavior. Managers attempting that kind of intervention can follow a three-step process: diagnosing the behavioral problem, designing an operating role for customers that creates new value for both parties, and testing and refining approaches for influencing behavior.
Commerce↗
Exposure, health information and flavour-masking strategies for improving the sensory quality of probiotic juice.
Probiotics are live microbial food supplements, which have been shown to exert numerous health benefits. Research has identified that probiotics cause perceptible off-flavours that often contribute to consumer dissatisfaction. This research consisted of three objectives. Firstly, to confirm whether probiotics have a significant effect on the sensory quality and the consumer acceptance of juices. Secondly, to evaluate whether the addition of tropical juices masks probiotic off-flavours, thereby increasing consumer liking. Thirdly, to determine whether non-sensory factors (i.e., repeated exposure, and health information) have an impact on consumer liking. Three orange juice products were manufactured for analysis; Control juice, juice containing probiotics, and juice containing probiotics and tropical fruit juices (10% v/v). Descriptive sensory analysis using a trained panel (n=8) determined that probiotic juices possessed unique 'medicinal' characteristics. Using labelled affective magnitude scales, consumers (n=116) evaluated their 'overall liking' of the three juices in a randomised order in the laboratory. Once assigned into one of three balanced exposure groups, each consumer took home seven, 100mL bottles of one of the juices, and consumed one bottle each day for 7 days. After each in-home consumption, consumers evaluated their 'overall liking' to familiarize themselves with the juice. Furthermore, half of the consumers were provided with information about the presence and the health benefits of probiotics, while the other half of consumers received no information. After 7 days of in-home usage, consumers returned to the laboratory for post-exposure sensory testing, where they re-evaluated their 'overall liking' of the three juices in a randomised order. Results showed that tropical juices were effective in masking the off-flavours associated with probiotic ingredients, and that consumer liking for the probiotic juice containing tropical juice flavours was maintained over the 7-day exposure period. Exposure and information had significant effects on the 'overall liking' of juices containing probiotic cultures. A significant interaction between exposure and information was observed. Therefore, exposure, health information and flavour-masking techniques can have a positive effect on the hedonic qualities of probiotic juices.
Adolescent↗
Consumer preferences for food product quality attributes from Swedish agriculture.
This paper employs a choice experiment to obtain consumer preferences and willingness to pay for food product quality attributes currently not available in Sweden. Data were obtained from a large mail survey and estimated with a random parameter logit model. We found evidence for intraproduct differences in consumer preferences for identical attributes, as well as interproduct discrepancies in ranking of attributes. Furthermore, we found evidence of a market failure relating to the potential use of genetically modified animal fodder. Finally, we found support for the idea that a cheap-talk script can alleviate problems of external validity of choice experiments. Our results are useful in forming product differentiation strategies within the food industry, as well as for the formation of food policy.
Agriculture↗
Beneficiary reported experience and voluntary disenrollment in Medicare managed care.
Disenrollment rates have often been used as indicators of health plan quality, because they are readily available and easily understood by purchasers, health plans, and consumers. Over the past few years, however, indicators that more directly measure technical quality and consumer experiences with care have become available. In this observational study, we examined the relationship between voluntary disenrollment rates from Medicare managed care (MMC) plans and other measures of health plan quality. The results demonstrate that voluntary disenrollment rates are strongly related to direct measures of patient experiences with care and are an important complement to other measures of health plan performance.
Centers for Medicare and Medicaid Services, U.S.↗
Free choice of sickness funds in regulated competition: evidence from Germany and The Netherlands.
Sickness funds became the focal point of health insurance reforms in the 1990s. Policy makers expected funds to become more consumer-oriented and more active in managing the provision of health care. This is especially true for two countries in the heart of Europe that, on first view, have many similar institutional characteristics. Both Germany and The Netherlands have introduced competition between sickness funds in the last decade. We present extensive quantitative, as well qualitative, data with regard to the behaviour of consumers after the introduction of free choice between sickness funds. National data was used with regard to contribution rates and member flows and survey data was used to investigate personal motives for actual change and perception of differences between sickness funds. In Germany, contribution rates between sickness funds differ significantly. Accordingly, these differences are the main reason for consumers to switch funds, which occurs on a considerable scale. However, survey data show that other reasons may be important too. In The Netherlands, premium differences are much lower. The same is true for the degree of change. Survey data show that consumers perceive very small differences between sickness funds and do not see much reason for change. Our findings support the claim that the degree of actual changing depends strongly on economic incentives, especially with regard to the extent of financial risk sickness funds have to bear and to the extent premiums or contribution rates can differ. However, the higher the financial risk of individual sickness funds actually is, the higher the incentives for risk selection.
Choice Behavior↗
Factors influencing consumers' selection of a primary care physician.
There is a growing body of literature regarding patient choice of health care plans, patient satisfaction, and patient evaluation of health care quality, but there is little information concerning the factors that influence the initial selection of a primary care physician (PCP). This exploratory study identifies and conceptualizes the physician selection dimensions which include: physician reputation/manner, physician record, physician search, consumer self-awareness, physician location, physician qualifications, physician demographics, office atmospherics, house calls/insurance, and valuing patient opinion. The study also develops and tests a scale for PCP selection using factor analysis which is demonstrated to be valid, and determines significant differences of variables, which include education level, gender, and age, using a summated scale. The study is of use to physicians in their targeting and communication strategies, and to researchers seeking to refine the scale.
Adolescent↗