The Spectrum Health Value Study

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According to a new survey called the Spectrum Health Value Study, when Americans were asked to value their most important health product and/or service as they consider spending their own money, they chose access to care over everything else [1]. Respondents indicated that access to physician services, medical services at a hospital and emergency care services are their most essential and highest valued health priorities.

The Institute of Medicine Roundtable on Evidence-Based Medicine brings together leaders from key healthcare sectors to accelerate the collaborative work necessary to drive improvements in the effectiveness and efficiency of medical care. According to a Roundtable issue brief published earlier this year [2]:

While the U.S. has the highest per capita spending on health care of any industrialized nation, health outcomes lag those achieved elsewhere. The increasing costs of care are reducing access to care and constitute an ever heavier burden on employers and consumers. To address both the costs and the performance of the health care system, greater consensus will be required on what constitutes value in health care, and how to measure and increase that value.

Indeed, value is a relative term — what’s valuable to me may not be valuable to you. With policymakers looking to overhaul the U.S. healthcare system, one way to quantify and compare the value of health programs, products and services is to ask consumers and taxpayers.

In the medical and healthcare industry, the U.S. government has assigned standard industry classification (SIC) codes to 27 programs, products and services for measuring economic activity in various sectors of the economy. The Spectrum Health Value Study, a national, online survey to ask Americans what they value when it comes to medical and healthcare products and services, is using those 27 SIC codes to identify the relative importance of each program, product or service. Additionally, the study aims to gain a better understanding of consumer use of each product and/or service, and to identify key segments of healthcare consumers.

Each quarter, beginning in January 2009, Spectrum, a Washington DC-based public relations and public affairs firm, will interview 1,000 repondents and ask them to identify from the 27 healthcare products, programs and services tested those ever used and how satisfied or not satisfied they were each. The results can be used to identify what Americans value in healthcare programs, products and services, and how the value changes over time.

Second quarter 2009 results

During the first two quarters of 2009, 2,025 respondents were interviewed. Half the respondents were men and half were women; half were married; 15% were African-American and 73% were White; 27% were aged 18 – 34, 41% were aged 35 – 54 and 33% were over the age of 55. The mean household income was $51,600. Sixty-one percent suffered from a health condition in the past year, and 78% of all respondents had insurance coverage.

The study found that four services: prescription drugs, over the counter drugs, dentist services and physician services have ‘ever been used’ by the vast majority of people; these are also the four services most commonly ‘used regularly’. Surgical services, over the counter drugs, dentist services, physician services, diagnostic laboratory services, prescription drugs and health/personal care goods were the highest rated services among the 27 tested. The lowest rated services included care for the elderly, health relief services, mental retardation services, mental health services, substance abuse services, preventive health services and individual social/health services.

Central to the Spectrum Health Value Study is the analysis of the relative value that respondents place on the 27 healthcare programs, products and services listed above. Each respondent was asked the following question several times, each time showing them a set of four different programs, products and services from the 27 being tested:

Recognizing that health care costs vary depending on your level of insurance coverage, and other health benefits that you either purchase or receive through an employer or other sources, and thinking about the actual dollars that are spent, listed below are four health care services with costs that you and other individuals ultimately pay for either directly or indirectly. Of these four, which is the most important and which is the least important for you and your family as you spend your health care dollars?

The following programs, products and services were picked as ‘most important’ more often than not:

Physician services
Medical services at a hospital
Emergency care services
Prescription drugs
Dentist services
Outpatient services
Diagnostic laboratory services
Surgical services
Preventive health services
Medical research
Over the counter drugs
Health/personal care goods
Individual social/health services

Afterward, respondents were shown the following statement:

The cost of health care benefits and services for Americans is — one way or the other — ultimately paid for by individuals who contribute in various ways. These various types of payments include insurance policy premiums that people pay, income and sales taxes people pay, employer deductions from employees’ paychecks, an individual’s out-of-pocket expenses or co-pays, as well as payments or personal charitable contributions to health providers. In summary, whatever the combination or method of funding for health care, the ultimate payer is the individual.

Sixty-nine percent of respondents agreed that the cost of healthcare benefits and services are ultimately paid for by individuals who contribute in various ways. People who suffer from a health condition were statistically more likely to answer that they strongly agreed with the statement than were people who do not have a health condition.

Several notable points:

Although respondents were not asked how much they value access to healthcare, those products and services associated with access were highest ranked in the analysis: physician services, medical services at a hospital, and emergency care services.
Although Americans strongly value preventive health services, they do not use them on a regular basis. When preventive health services are used, Americans are not very satisfied with the quality service.
Despite the attention being raised around the obesity epidemic, Americans neither value nor use nutrition services. When nutrition services are used, they are not considered very satisfactory.

Spectrum plans to update the study findings each quarter. Additional details as well as access to the full report can be read at http://www.healthvaluestudy.com/. Several summary reports are available (for each page below, click on ‘Download Full Report’):