Jon Christianson,1 Daniel Maeng,2 Jean Abraham,1 Dennis P. Scanlon,3 Jeffrey Alexander, 4 Jessica Mittler,3 and Michael Finch5
1University of Minnesota School of Public Health—Division of Health Policy and Management 2Geisinger Health System—Center for Health Research 3The Pennsylvania State University—Department of Health Policy & Administration 4University of Michigan—Health Management and Policy 5Finch and King Consulting
Objective: Examine the factors that are associated with awareness of physician quality information (PQI) among older people with one or more chronic illnesses and the implications for Medicare. Data Sources/Study Setting: Random digit-dial survey of adults with one or more chronic illnesses. Research Design: Structural equation modeling to examine factors related to awareness of PQI. Results: Awareness of PQI is low (13 percent), but comparable to findings in general population surveys. Age, race, education, and self-reported health status are associated with PQI awareness. Trust in the Internet as a source of health care information and not trusting one’s physician as a source of information both are associated with a greater likelihood of being aware of PQI. Patients with high levels of activation have greater trust in physicians as information sources, but this is not associated with awareness, nor is degree of satisfaction with their care experience. Conclusions: Awareness of PQI among older persons with chronic illnesses is relatively low across all socio-economic and demographic subgroups. Changes in population characteristics over time are unlikely to improve awareness in this population, nor are changes in patient activation or satisfaction with care. Medicare would need a broad-based effort if it wishes to raise PQI awareness among Medicare beneficiaries in the near term. Before undertaking resource-intensive efforts to increase awareness, Medicare may want to consider what level of
awareness actually is needed to accomplish the overall objective for PQI transparency, which is raising the quality of care received by beneficiaries. It may be that relatively low levels of awareness are sufficient.
Keywords: awareness of physician quality measures, patient activation, public reporting, older persons, Medicare, chronic illness