Grant: #73053

Grantee Institution: University of California at Irvine

Principal Investigator: Dana B. Mukamel, Ph.D.

Grant Period: October 1, 2015 – December 31, 2017

Budget: $399,997

Project Aim: To examine patient expectations and satisfaction and translate findings into user-friendly scenarios via an interactive website for providers, insurers and policymakers, which could predict how a specified patient population will be distributed across a range of care settings based on their preferences.

Key Findings:

  • Out-of-pocket costs and wait time had minimal impact of patient preference for care settings. Choices were driven primarily by the clinical scenario (i.e. the severity of the ailment or illness).
  • Patients were less likely to “wait-and-see” if a condition resolved before seeking care for their children.
  • Patients were more likely to choose office settings for chronic conditions, but were more likely to choose the emergency room (for high severity) or urgent care (for lower severity) for acute conditions.
  • Patient race, education, age, and preferred language had effects on the care setting they chose.
  • There might be other barriers to switching between traditional and new care‐setting options, in addition to out-of-pocket costs and wait time.

Project Description: 

Utilizing a web-based survey to all University of California at Irvine employees, estimated at about 29,000 individuals, the researchers examined the preferences of faculty, staff, student employees and retirees around various health care settings, comparing new modalities, like retail clinics and telehealth, to traditional settings, such as physician offices or emergency departments, to investigate the factors that influence their selection. The survey utilized specially designed preference and value web-based interactive elicitation tools to obtain responses to both hypothetical choices under pre-specified scenarios and based on actual experience. The goal of this project was to offer benchmarking information on patient expectations and satisfaction as well as translate findings into user-friendly scenarios via an interactive website for providers, insurers and policymakers, which could predict how a specified patient population will be distributed across a range of care settings based on their preferences.

This project was funded as part of the Robert Wood Johnson Foundation’s solicitation “Optimizing Value in Health Care: Consumer-focused Trends from the Field,” which supported studies that addressed consumer perceptions of value in the new and emerging health care landscape.

Publications

Where Do Patients Go? How Patients Choose Between Care Settings for Minor Illnesses and Injuries
UCLA | September 2019

Patients' Preferences Over Care Settings for Minor Illnesses and Injuries
Health Services Research | April 2019

Alternatives to Care in Physician Offices: Patients’ Expectations and Satisfaction
Journal of General Internal Medicine | October 2018