PATIENT PREFERENCES FOR DISCLOSURE: A NATIONAL SURVEY

患者的披露偏好：全国调查

• 批准号: 6185578
• 负责人: WENDY LEVINSON
• 金额: $ 5.7万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-15 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6185578
• 关键词: clinical research; decision making; health care personnel; health care policy; health care professional practice; health care service evaluation; health insurance; health related legal; health services research tag; health surveys; human subject; patient care management; patient care planning; population survey; preference

In the changing health care environment, important decisions previously made by patients and their physicians are now strongly influenced by third parties such as health plans and insurers whose intrusion has led many patients to question whether their physicians are truly acting in their best interest. Physicians report that they are challenged in knowing how to communicate effectively with patients about third-party restrictions while simultaneously building trust and maintaining patient satisfaction. This study proposes to answer this question by eliciting patient opinions on how and when they should be informed about third-party policies, particularly referral-restrictions and conflicts of interest. Through a national survey based on a representative sample of the US population, respondents will be exposed to different communication strategies used by physicians to disclose referral restrictions and financial conflicts of interest. These statements will reflect the highest standards of professional conduct and will be based on the assumption that physicians act within ethical parameters. The specific objectives of this research proposal are as follows: (1) develop communication strategies for disclosure of third-party restrictions by physicians and evaluate their authenticity and acceptability; (2) pilot test a survey instrument (containing audiotaped statements of disclosure of third-party restrictions) among patients from high and low penetration managed care markets; (3) experimentally evaluate public preferences on how information regarding third-party restrictions should be implemented through the nationally representative General Social Survey (GSS) administered by the National Opinion Research Center (NORC); (4) Evaluate how disclosure of third-party restrictions affects outcomes of patient trust, satisfaction, and intent to disenroll from health plan; and (5) evaluate how disclosure outcomes vary based on patients' experience with third-party restrictions, health status, and other demographic characteristics. The results will provide the basis for policy decisions for both legislative bodies and health care organizations responsible for disclosure to patients and the public at large. The study will form the basis of broadly disseminated educational interventions for physicians helping them to disclose information about third-party restrictions in manner that reinforces the therapeutic patient-physician relationship.

在不断变化的医疗保健环境中，先前由患者及其医生做出的重要决定受到第三方和保险公司等第三方的强烈影响，这些计划和保险公司的侵入使许多患者质疑其医生是否真正符合他们的最大利益。 医师报告说，他们在知道如何与患者有效沟通第三方限制的同时，同时建立信任并维持患者满意度时受到挑战。 这项研究建议通过引起患者对如何以及何时应了解第三方政策的意见来回答这个问题，尤其是推荐限制和利益冲突。 通过基于美国人口的代表性样本的全国调查，受访者将暴露于医生使用的不同沟通策略，以披露转诊限制和财务冲突。 这些陈述将反映出专业行为的最高标准，并基于医师在道德参数中行事的假设。该研究建议的具体目标如下：（1）制定医生披露第三方限制的沟通策略，并评估其真实性和可接受性； （2）试点测试工具（包含来自渗透率和低渗透率托管护理市场的患者中的录音带披露的第三方限制披露陈述）； （3）实验评估公众对如何通过国家意见研究中心（NORC）管理的全国代表性一般社会调查（GSS）实施有关第三方限制的信息； （4）评估第三方限制的披露如何影响患者信任，满意度和意图剥夺健康计划的结果； （5）评估披露结果如何根据患者在第三方限制，健康状况和其他人口特征方面的经验而变化。结果将为立法机构和医疗保健组织的政策决策提供基础，负责向患者和整个公众披露。 这项研究将构成广泛传播教育干预措施的基础，以帮助他们以方式披露有关第三方限制的信息，从而增强治疗性患者 - 医师关系。