Many Americans with health insurance aren't embracing evidence-based healthcare because of misconceptions and a lack of knowledge, according to a new study in Health Affairs.
"Evidence That Consumers Are Skeptical about Evidence-Based Health Care" examines the values, beliefs and behaviors that challenge efforts to engage consumers in evidence-based decision-making. The research was conducted by the American Institutes for Research in collaboration with the National Business Group on Health and supported by the California HealthCare Foundation.
A key finding: Most consumers believe that more – and more costly – care means better care.
According to the online survey, 47 percent of respondents agreed that it is reasonable to pay less out of pocket for the most effective treatments and drugs.
Thirty-three percent of survey participants 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.
"Consumers believe that new types of care and treatment are always better – it's hard for them to accept evidence to the contrary," said Kristin L. Carman, the study's lead author and co-director of health policy and research analysis at AIR in Washington, D.C.
Study participants did not generally understand that variations exist in the quality of care; the study's authors said; many assumed their providers make all care decisions based on existing medical evidence.
The research suggests that consumers are often reluctant to question or challenge their doctors because they rely heavily on them for information, interpretation and guidance for treatment options.
Many respondents did not engage in behaviors that could help them become better medical decision-makers. For example, 55 percent said they never take notes during medical appointments, and 28 percent said they never prepare questions in advance to ask their doctors.
The authors note that it will be difficult to motivate consumers to accept evidence-based medicine given that healthcare decisions are becoming increasingly complex and the general public has relatively low levels of health and scientific literacy.
The study collected data between August 2006 and December 2007 from four focus groups involving 34 consumers and one-on-one interviews with 57 individuals.
The authors also conducted interviews with 40 "employer intermediaries" who regularly communicate about healthcare, such as human resource personnel, and gathered data from an online survey of more than 1,500 employees, commissioned by the National Business Group on Health in September 2007.