Asunto(s)
Curriculum , Salud Pública , Investigación , Estudiantes de Medicina , Escritura , Humanos , Edición/tendenciasRESUMEN
Improving Medicaid program effectiveness for underserved populations is hampered by low survey response rates. This study determined how to maximize Medicaid consumer satisfaction survey response rates to the Consumer Assessment of Health Plans Study (CAHPS) survey. In a public immunization clinic, 8 focus groups and 15 extended interviews were used to assess consumer-preferred survey design features and incentives. To test hypotheses, we conducted the following trial. Out of 10,733 total participants in a Kansas Medicaid managed care plan, 3,685 eligible for CAHPS were unduplicated by household. After randomization of the 968 households with valid addresses to one of three groups, a controlled trial was conducted to assess response rates to CAHPS survey formats and incentives. Response rates were 35% for a standard mailing, 44% for a user-friendly low-literacy mailing, and 64% for a user-friendly low-literacy mailing with a $10 contingent incentive. Both experimental arms significantly improved response compared with the control; the response rate of the mailing group with the incentive was higher than the response rate of the group receiving that mailing without any incentive (p<0.0001). Using consumer-based preferences significantly increased response rates to this Medicaid satisfaction survey. Raising CAHPS response rates may increase validity of Medicaid consumer satisfaction information.
Asunto(s)
Comportamiento del Consumidor/estadística & datos numéricos , Encuestas de Atención de la Salud/métodos , Programas Controlados de Atención en Salud/normas , Medicaid/normas , Pobreza , Clase Social , Adolescente , Adulto , Centers for Medicare and Medicaid Services, U.S. , Femenino , Humanos , Kansas , Masculino , Motivación , Servicios Postales , Proyectos de Investigación , Factores Socioeconómicos , Encuestas y Cuestionarios , Estados UnidosRESUMEN
Telephone triage programs have been shown to be cost-effective and favorably utilized by insured populations. However, there are 45 million Americans who are uninsured and who do not have access to telephone nursing. A telephone triage service was piloted for local uninsured residents. Within the 17-month trial period, 320 calls were received, representing 207 clients. This study reports on the results of the telephone survey with a cross-sectional sample of uninsured triage patrons (N = 80). One half reported they would have sought other medical care if the telephone triage service had not been available. Most callers (98%) believed that their health care concern was understood. Moreover, 98% agreed with the advice given, and 90% reported following up on the advice given. Overall satisfaction by the uninsured population with the telephone-based nurse triage service was positive and appears to be an effective and acceptable tool by those uninsured individuals who utilized its services.
Asunto(s)
Servicios de Salud Comunitaria/organización & administración , Líneas Directas/organización & administración , Pacientes no Asegurados , Atención de Enfermería/organización & administración , Satisfacción del Paciente , Adulto , Servicios de Salud Comunitaria/estadística & datos numéricos , Escolaridad , Femenino , Líneas Directas/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
Health numeracy has often been overshadowed by health literacy, either ignored completely or identified simply as a subset of health literacy. Only now are researchers beginning to realize the importance of health numeracy as a separate entity. One of the first steps in this evolution is to establish a distinct definition for health numeracy, something that has not been addressed in the literature to date. This paper proposes such a definition, as well as a set of clarifying categories in hopes of helping researchers both to advance the field of health numeracy and to focus their topics within the realm of health numeracy.
Asunto(s)
Educación en Salud , Barreras de Comunicación , Escolaridad , Humanos , Matemática , Estadística como Asunto/educaciónRESUMEN
BACKGROUND: Medicaid-insured asthmatic children frequently use emergency rooms (ERs). The reasons are unclear and have predominantly been studied in inner-city populations. METHODS: We used billing data and focus groups to clarify reasons for frequent ER use by Medicaid-insured children with asthma living in rural areas and 23 towns in Kansas. RESULTS: High ER utilization was concentrated in a small percentage of provider practices and children with asthma. Parents expressed strong preference for primary care treatment, and identified real or perceived difficulties in using primary care as the principal reasons for ER use. Difficulties included trouble contacting primary care physicians or obtaining urgent appointments, limited continuity of care, practice systems poorly adapted to patient needs, a perception that physicians preferred patients to use emergency services, and difficulties in obtaining medications. Parents were not aware of preventive measures or case management but reported high interest in these. Parents did not recall provider discussion of asthma risk factors/preventive strategies during primary care visits, although all children with high ER utilization had multiple risk factors, including exposure to high levels of household smoking. CONCLUSIONS: Reducing ER utilization by Medicaid-insured asthmatic children depends on overcoming barriers to effective treatment in primary care and in greater attention to preventive services.