Robert Wood Johnson Foundation Health Priorities Survey Report: The Medical System and the Uninsured

Presents results of a survey on the healthcare system, priorities for reform, and views on the uninsured, a public insurance plan, and individual mandates, compared with other surveys. Analyzes how the way reform elements are described affects responses

African American Men Survey

A comprehensive survey looking at how African-American men view their lives in the United States and their outlook for the future. The survey gauges the views and experiences of African-American men on marriage and family, education, careers and health, among other issues, and includes comparisons to the views and experiences of African-American women and white men and women. The African-American Men Survey is the 15th survey in a series generated under a three-way partnership between The Washington Post, the Kaiser Family Foundation and Harvard University. The three organizations work together to pick the survey topics, design the survey instruments and analyze the results. The survey's findings were published in the June 4, 2006, edition of The Washington Post. This survey was conducted by telephone from March 20 to April 29, 2006, among 2,864 randomly selected adults nationwide, including: 1,328 black men; 507 black women; 437 white men and 495 white women. Results for total respondents have been weighted so that black respondents are represented in proportion to their actual share of the population. Margin of sampling error is plus or minus 3 percentage points for results based on all respondents or black men, 5 percentage points for black women and 6 percentage points for white men or women. Hispanics and Asians were interviewed along with white and black respondents, but because of the relative size of those populations, there were not enough respondents to break out separately. The complete survey results and detailed methodology description are available in the toplines document

Employment and Compliance with Pandemic Influenza Mitigation Recommendations

Noncompliance may result from job insecurity and financial problems associated with missing work

The causes and circumstances of drinking water incidents impact consumer behaviour:Comparison of a routine versus a natural disaster incident

When public health is endangered, the general public can only protect themselves if timely messages are received and understood. Previous research has shown that the cause of threats to public health can affect risk perception and behaviours. This study compares compliance to public health advice and consumer behaviour during two "Boil Water" notices issued in the UK due to a routine incident versus a natural disaster incident. A postal questionnaire was sent to 1000 randomly selected households issued a routine "Boil Water" notice. Findings were then compared to a previous study that explored drinking water behaviour during a "Boil Water" notice issued after serious floods. Consumers affected by the routine incident showed a significant preference for official water company information, whereas consumers affected by the natural disaster preferred local information sources. Confusion over which notice was in place was found for both incidents. Non-compliance was significantly higher for the natural disaster (48.3%) than the routine incident (35.4%). For the routine incident, compliance with advice on drinking as well as preparing/cooking food and brushing teeth was positively associated with receiving advice from the local radio, while the opposite was true for those receiving advice from the water company/leaflet through the post; we suggest this may largely be due to confusion over needing boiled tap water for brushing teeth. No associations were found for demographic factors. We conclude that information dissemination plans should be tailored to the circumstances under which the advice is issued. Water companies should seek to educate the general public about water notices and which actions are safe and unsafe during which notice, as well as construct and disseminate clearer advice on brushing teeth and preparing/cooking food

Would you want to know? Public attitudes on early diagnostic testing for Alzheimer's disease

INTRODUCTION: Research is underway to develop an early medical test for Alzheimer's disease (AD). METHODS: To evaluate potential demand for such a test, we conducted a cross-sectional telephone survey of 2,678 randomly selected adults across the United States and four European countries. RESULTS: Most surveyed adults (67%) reported that they are "somewhat" or "very likely" to get an early medical test if one becomes available in the future. Interest was higher among those worried about developing AD, those with an immediate blood relative with AD, and those who have served as caregivers for AD patients. Older respondents and those living in Spain and Poland also exhibited greater interest in testing. Knowing AD is a fatal condition did not influence demand for testing, except among those with an immediate blood relative with the disease. CONCLUSIONS: Potential demand for early medical testing for AD could be high. A predictive test could not only advance medical research, it could transform political and legal landscapes by creating a large constituency of asymptomatic, diagnosed adults

Country differences in the diagnosis and management of coronary heart disease : a comparison between the US, the UK and Germany

Background The way patients with coronary heart disease (CHD) are treated is partly determined by non-medical factors. There is a solid body of evidence that patient and physician characteristics influence doctors' management decisions. Relatively little is known about the role of structural issues in the decision making process. This study focuses on the question whether doctors' diagnostic and therapeutic decisions are influenced by the health care system in which they take place. This non-medical determinant of medical decision-making was investigated in an international research project in the US, the UK and Germany. Methods Videotaped patients within an experimental study design were used. Experienced actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patients of different sex, age and social status. The videotapes were shown to 384 randomly selected primary care physicians in the three countries under study. The sample was stratified on gender and duration of professional experience. Physicians were asked how they would diagnose and manage the patient after watching the video vignette using a questionnaire with standardised and open-ended questions. Results Results show only small differences in decision making between British and American physicians in essential aspects of care. About 90% of the UK and US doctors identified CHD as one of the possible diagnoses. Further similarities were found in test ordering and lifestyle advice. Some differences between the US and UK were found in the certainty of the diagnoses, prescribed medications and referral behaviour. There are numerous significant differences between Germany and the other two countries. German physicians would ask fewer questions, they would order fewer tests, prescribe fewer medications and give less lifestyle advice. Conclusion Although all physicians in the three countries under study were presented exactly the same patient, some disparities in the diagnostic and patient management decisions were evident. Since other possible influences on doctors treatment decisions are controlled within the experimental design, characteristics of the health care system seem to be a crucial factor within the decision making process

A four-country survey of public attitudes towards restricting healthcare costs by limiting the use of high-cost medical interventions

Objective: To discern how the public in four countries, each with unique health systems and cultures, feels about efforts to restrain healthcare costs by limiting the use of high-cost prescription drugs and medical/surgical treatments. Design: Cross-sectional survey. Setting: Adult populations in Germany, Italy, the UK and the USA. Participants: 2517 adults in the four countries. A questionnaire survey conducted by telephone (landline and cell) with randomly selected adults in each of the four countries. Main outcome measures: Support for different rationales for not providing/paying for high-cost prescription drugs/medical or surgical treatments, measured in the aggregate and using four case examples derived from actual decisions. Measures of public attitudes about specific policies involving comparative effectiveness and cost-benefit decision making. Results: The survey finds support among publics in four countries for decisions that limit the use of high-cost prescription drugs/treatments when some other drug/treatment is available that works equally well but costs less. The survey finds little public support, either in individual case examples or when asked in the aggregate, for decisions in which prescription drugs/treatments are denied on the basis of cost or various definitions of benefits. The main results are based on majorities of the public in each country supporting or opposing each measure. Conclusions: The survey findings indicate that the public distinguishes in practice between the concepts of comparative effectiveness and cost-effectiveness analysis. This suggests that public authorities engaged in decision-making activities will find much more public support if they are dealing with the first type of decision than with the second

Helping Consumers Make High‐Value Health Care Choices: The Devil Is in the Details

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145317/1/hesr12860.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145317/2/hesr12860_am.pd