Survey Research Informs Healthcare Decisions

Survey Research Informs Healthcare Decisions

Have you completed these types of healthcare surveys?

Sandy had surgery on her vocal cords and was an inpatient for four days. Before she was discharged, she was given a questionnaire and asked to describe her level of satisfaction with hospital services that included the admissions process, her hospital room, food service, nurses, physicians, tests, and treatments. She was also asked to indicate her level of satisfaction with staff attitudes towards her visitors and to describe the degree to which staff addressed her emotional needs.

Sandy’s feedback was based on a scale that included very dissatisfied, somewhat dissatisfied, neutral, somewhat satisfied, very satisfied, and does not apply; she was asked to describe any particularly good or bad experiences in the open-ended comments section.

Keith used the physician referral service for a hospital consortium in a small town. Two days later, he received a two-page questionnaire in the mail along with a postage paid envelope asking him to rate the Physician Referral Services and staff. He assessed his overall experience by rating staff on a scale of very poor, poor, fair, good, and very good on ease of using the service, convenience of hours, the degree to which staff understood his needs, clarity of staff responses, and staff attitudes. Open-ended items asked his preference for appointment days and times and how he found out about the referral service.

Keith was also asked whether he ultimately made an appointment with one of the hospital physicians after using the referral service. If yes, he was then asked to rate the friendliness and helpfulness of the staff, waiting room environment, and wait time for that physician. At the end of the questionnaire he was provided with a telephone number, in case he wanted to speak with someone about his experience.

Most of us have completed similar questionnaires. We’re asked for our feedback about physician, nurse and staff behavior, communications, friendliness and helpfulness, wait times, billing, cleanliness, parking, the website, and other areas of operation. We trust that hospitals and physician offices use our feedback to assess and improve their services, but we never know with certainty whether this is the case or not.

What is certain, however, is that surveys in the healthcare industry have proliferated to address such topics as disparities in care, medical errors, quality care, patient safety, health care costs, health literacy, cultural competency, consumer attitudes, physician satisfaction, health care worker engagement, and health policy issues. Special topics becoming more commonplace in healthcare survey research include bio terrorism, emergency preparedness, and electronic medical records.

Surveys are often used as a form of needs assessment in which strengths and weaknesses of the organization or medical practice are paired with the opportunities and threats presented by the external environment to inform strategic business decisions. Some survey research companies even have methods of analyses that drill down to identify the root causes of dysfunction, which helps ensure that targeted action will be taken based on feedback received.

Many entities conduct survey research related to health issues, including local, state, and federal government agencies, professional membership associations, hospitals and teaching medical centers, physician and dental practices, freestanding clinics, private foundations, not-for-profit and for-profit organizations, and survey research firms.

The National Health Care Surveys are conducted by the Division of Health Care Statistics, National Center for Health Statistics of the Centers for Disease Control and Prevention. The National Hospital Care Survey began in 2011, taking inpatient information previously collected by the National Health Discharge Survey and integrating it with information from emergency and outpatient departments and ambulatory surgery centers. The National Hospital Care Survey sampled 500 non-federal hospitals with six or more beds in the United States.

Data gathered in 2011-2012 included administrative claim data for all inpatients and facility information. Hospitals continue to collect that information along with data on the utilization of health care services given in hospital emergency and outpatient departments, and ambulatory care centers.

Data gathered from this survey is used to answer questions posed by researchers and policy decision makers, questions related to quality of health care, drivers of health care costs, and health care reform.

The Department of Health & Human Services oversees the Agency for Healthcare Research and Quality, which implements the Medical Expenditure Panel Survey, a longitudinal, nationally representative survey. Touted as the most complete source of data on the cost and use of health care and health insurance coverage in the United States, the Medical Expenditure Panel Survey is made up of a collection of surveys that gather information from families and individuals, medical care providers, and employers in the private sector, state, and local governments.

Data from each of the surveys and a series of data tables are available through the Agency website; interactive statistical tools are available on MEPSnet. Information gathered includes health status of Americans, the status of their health insurance coverage, access to health care, and cost of health services. Information from insurers includes number and type of private health insurance plans offered, plan benefits, cost of annual premiums, and the percent of the premium paid by employers and employees.

Policy decision makers and analytical researchers use this data to inform legislative, business, and operational business decisions. Such decisions are also informed by surveys conducted by private, for-profit organizations.

In use since about 2007, the Survey of U.S. Health Care Consumers provides evidence-based information of consumer opinions about health care reform, consumer behaviors, and their perceptions of the health delivery system in the United States. The data gathered reveals that consumer behavior regarding health care has changed significantly since 2007.

The Survey of U.S. Health Care Consumers reveals six different types of health care consumers, each with a specific point of view and health care need. The ‘content and compliant’ and ‘sick and savvy’ consumers obey the directive of a health care professional. The ‘casual and cautious’ do not see the need to engage with the health care system while those who are ‘out and about’ use non-Western medicines. The ‘online and onboard’ consumers compare health information online and through mobile apps while ‘shop and save’ consumers shop around for the least expensive health care service or product.

About 78% of consumers surveyed state they are not satisfied with the performance of the existing health care system. An average 35% of respondents express concerns with the privacy and security of electronic health records (i.e., Millennials at 30% and Boomers at 39%). Overall, enthusiasm for health care reform is ebbing, although most respondents feel better about the health care they receive than they do about the health care system.

These survey results have implications for the future of health care delivery, needed products and services, requisite marketing and business strategies, and diverse customer service models to support it all. When survey results are compared with or are otherwise integrated with results from other surveys, even more findings and strategic implications emerge. Such surveys include the U.S. and Global Survey of Health Care Consumers and the Survey of U.S. Physicians.

The Survey of U.S. Physicians focuses on adoption and use of health information technologies in medical practices; data show that both are problematic due to the cost of replacing information technology systems or integrating new technology with old – compounded by the cost of training office staff and physicians.

Often industry leaders conduct their own surveys or commission such studies to be done to support or inform business decisions. One such survey polled a global sample of 5,000 adults aged 18-69 in Australia, France, Germany, the United Kingdom, and the United States. Respondents had to be active Internet users and made an online purchase in the six months prior to the online survey.

The survey revealed that U.S. consumers are ready for more high-tech solutions in health care. Australians are also ready for a more digital approach to healthcare, finding that Australians believe doctors should have access to the electronic health information of their patients. This is timely news, since the Australian government is actively signing up eHealth users.

Many private foundations conduct surveys related to health care in conjunction with, or independently of, other entities. The Robert Wood Johnson Foundation conducted a survey on consumer attitudes and beliefs about rising health care costs and the subsequent impact on households in the United States. Eight focus groups were conducted in Chicago, Philadelphia, Denver, and Charlotte, North Carolina. Half of the focus groups were made up of individuals who had health insurance through their employers. Two groups were made up of people who purchased insurance on the private market. One group was covered by Medicare and one group was uninsured.

Not surprisingly, results noted that focus group participants are changing how they access health care and how they function within the system. Most participants stated that they ask more questions than ever before, even of their physicians. They compare costs more carefully and search for quality care. Some even state that they put off seeking care altogether.

Headquartered in New York City, the mission of The Commonwealth Fund is to promote a high performance health care system that affords access, quality and efficiency, particularly for those most vulnerable – young children and those with low incomes or no insurance. The latest Commonwealth Fund Biennial Health Insurance Survey included a sample of 4,432 adults aged 19 and older who live in the continental United States. The survey was implemented using 25 minute telephone interviews conducted in either English or Spanish.

The report revealed that 84 million people, almost half of all adults old enough to work in the United States, are without health insurance or were underinsured because of skyrocketing out of pocket costs. Certainly this has implications for health care policymakers!

Survey research is an effective way to inform policy and business decisions, yet many entities do not have the capability internally to develop and implement a survey research agenda. One option is to work with a survey research firm to conduct a needs assessment, develop goals and measurable outcomes, and identify survey methods, information sources, points at which data can be collected, along with methods of analysis and reporting.

Survey research related to health care in the United States definitely provides hard data, evidence of fact, behavior and attitude information that informs those who make decisions about the health care system.

To learn how NBRI can work with your health care organization to inform business decisions, contact us now at 1-800-756-6168.