A Qualitative Study of Vulnerable Patient Views of Type 2 Diabetes Consumer Reports

  • Daniel R. Longo
  • Benjamin F. Crabtree
  • Maria B. Pellerano
  • Jenna Howard
  • Barry Saver
  • Edward L. Hannan
  • Justin Lee
  • Michael T. Lundberg
  • Roy Sabo
Original Research Article

Abstract

Background

The Patient Protection and Affordable Care Act (ACA) mandates the release of publicly available consumer reports to highlight differences in quality of care and reduce healthcare disparities. However, little is known about patient perceptions of the value of such reports.

Objective

This study aims to identify whether vulnerable populations with type 2 diabetes perceive consumer reports as helpful in making decisions about diabetes care.

Methods

We conducted a brief demographic survey and qualitative study of 18 focus groups: six each of African American, Hispanic, and non-Hispanic White consumers diagnosed with type 2 diabetes (n = 92). We analysed focus group transcripts to identify recurring themes, which were summarized and compared across population groups.

Results

Participants expressed minimal interest in currently available consumer reports. They instead listed personal referrals and interpersonal interactions among the most important factors when choosing a physician. Further, in place of information to aid in physician selection, participants articulated strong desires for more basic, straightforward disease-specific information that would promote diabetes self-management.

Conclusions

This study’s results call into question the value of consumer reports as defined by the ACA. Participants reported little interest in comparative provider performance data. Instead, they were more interested in information to assist in diabetes self-management. This suggests that consumer reports may not be as important a tool to improve outcomes and reduce health disparities as policy makers imagine them to be.

Notes

Acknowledgments

Shannon D. Jones moderated the African American focus groups, Melissa Hayes and Justin Lee recruited participants for the focus groups, and Dr. Mark Ryan and Dr. Carmen Zorrilla provided support to Dr. Lee with regard to the Hispanic focus groups. Heather Longo provided editorial services.

Author contributions

Drs. Longo and Crabtree had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Longo, Lundberg, Hannan. Acquisition of data: Longo and Lee. Analysis and interpretation of data: Longo, Crabtree, Pellerano, Howard, Sabo. Critical revision of the manuscript for important intellectual content: Longo, Crabtree, Pellerano, Howard, Saver, Hannan, Lundberg, Sabo. Qualitative analysis: Crabtree, Pellerano, Howard, Longo. Administrative, technical, and material support: Longo and Lee. Study supervision: Longo and Crabtree.

Compliance with Ethical Standards

The study was approved by the appropriate Institutional Review Boards and has been performed in accordance with the ethical standards of the Declaration of Helsinki.

Informed consent was obtained from all individual participants included in the study.

Conflict of interest disclosures

The authors (Longo, Crabtree, Pellerano, Howard, Saver, Hannan, Lee, Lundberg, and Sabo) have completed and submitted the Adis Form for Disclosure of Potential Conflicts of Interest, and none were reported.

Funding/support

Funding by the Agency for Healthcare Research and Policy (AHRQ) grant number 1R21 HS021902-01.

Role of the sponsor

The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Prior presentations

Longo DR, Wright B, Lee J. Public reporting as a communication tool to aid vulnerable consumers in healthcare decisions: what do we know? AcademyHealth; Annual Research Meeting, Baltimore, MD, USA; 23 June 2013.

Lee J, Longo DR, Crabtree B, Howard J, Pellerano M. What do patients who are vulnerable want in publicly available health care consumer reports? AcademyHealth; Annual Research Meeting, San Diego, CA, USA; 10 June 2014.

Longo DR. Engaging vulnerable consumers in developing useful public health reports. AHRQ Building the Science of Public Reporting: Grantee Meeting at Academy Health; 10 June 2014.

Supplementary material

40271_2015_146_MOESM1_ESM.docx (478 kb)
Supplementary material 1 (DOCX 477 kb)

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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Daniel R. Longo
    • 1
  • Benjamin F. Crabtree
    • 2
  • Maria B. Pellerano
    • 2
  • Jenna Howard
    • 2
  • Barry Saver
    • 3
  • Edward L. Hannan
    • 4
  • Justin Lee
    • 5
  • Michael T. Lundberg
    • 6
  • Roy Sabo
    • 7
  1. 1.Department of Family Medicine and Population HealthVirginia Commonwealth UniversityRichmondUSA
  2. 2.Department of Family and Community MedicineRutgers Robert Wood Johnson Medical SchoolSomersetUSA
  3. 3.University of Massachusetts Medical SchoolWorcesterUSA
  4. 4.University at Albany, State University of New YorkAlbanyUSA
  5. 5.University of North Carolina at GreensboroGreensboroUSA
  6. 6.Virginia Health InformationRichmondUSA
  7. 7.Department of BiostatisticsVirginia Commonwealth UniversityRichmondUSA

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