When parents are given greater access to health information, does it affect pediatric utilization?
When parents are given greater access to health information, does it affect pediatric utilization?
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DOI：
10.1097/00005650-200108000-00010
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发表时间：
2001-08-01
期刊：
影响因子：
3
通讯作者：
Greenlick, MR
中科院分区：
文献类型：
--
作者：
Wagner, TH;Greenlick, MR
OBJECTIVE.大多数评估消费者健康信息对医疗利用的影响的研究都使用了慢性病患者的随机对照临床试验。在本文中，我们分析了健康社区项目，一个自然的实验，提供免费的自我保健资源，对报告的儿科利用的影响。在博伊西、爱达荷州和两个对照社区进行干预前后的随机家庭调查。调查共完成5，909次，整体回应率为54%。其中，1，812名受访者年龄在18至55岁之间，家中有18岁以下的子女。所有分析仅限于这1，812人。父母被问及他们的孩子在过去一年中看过多少次医生。使用分类反应量表收集反应，然后将其转换为连续变量（儿科就诊次数）。干预与报告的儿科使用率下降有关。访视次数的减少范围为-0.72至-0.66（P约为0.05），具体取决于所用的统计模型。对423个随时间随访的家庭的进一步分析发现，下降幅度较小（-0.19），但无统计学显著性。这项研究发现，越来越多的自我保健书籍，电话咨询护士，和基于互联网的健康信息与报告的儿科利用率下降。然而，结果的显著性对统计模型敏感。需要更多的研究来了解向消费者提供健康信息的平均成本和边际成本。
OBJECTIVE. Most studies assessing the effects of consumer health information on medical utilization have used randomized controlled clinical trials with the chronically ill. In this paper, we analyze the effect of the Healthwise Communities Project, a natural experiment that provided free self-care resources, on reported pediatric utilization.RESEARCH RESIGN. Random household surveys were collected before and after the intervention in Boise, Idaho and in two control communities.SUBJECTS. A total of 5,909 surveys were completed, representing an overall response rate of 54%. Of these, 1,812 respondents were between 18 and 55 years of age and had children under 18 years of age living in the home. All analyses were restricted to these 1,812 persons.MEASURES. Parents were asked how many times their children visited a physician in the last year. Responses were gathered with a categorical response scale, which was then transformed into a continuous variable (number of pediatric visits).RESULTS. The intervention was associated with a decrease in reported pediatric utilization rates. The decrease in visits ranged from -0.72 to -0.66 (P approximate to0.05), depending on the statistical model used. Further analyses of 423 families followed over time found a more modest decrease (-0.19) that was not statistically significant.CONCLUSIONS. This study found that increasing access to self-care books, telephone advice nurses, and Internet-based health information is associated with decreases in reported pediatric utilization. However, the significance of the results was sensitive to the statistical model. More research is needed to understand the average and marginal costs of providing health information to consumers.