Cost Is Lesser Factor in Assessing Health Care Quality, But Increases Are Affecting Use, Survey Conc

November 26, 2014

Americans tend to consider factors other than cost when assessing health care quality, according to the results of the 2005 Health Confidence Survey (HCS) published by the Employee Benefit Research Institute (EBRI). However, insured Americans who have seen their costs go up are changing the way they use health care, the survey found.

The HCS examined what survey participants considered to be "quality" health care. In assessing a provider, topping the list were the skills, experience and training of the doctor (considered by 97% as very important), followed by the provider's willingness to listen and explain things to them (90%), and the provider's personal manner, sensitivity and respect shown for the patient (80%). Factors not directly related to the provider but considered important included the degree of control the individual has over health care decisions (90%), the timeliness (89%) and ease (85%) of getting care and treatment, and the ability of a doctor or hospital to access patient medical records (81%).

While 79% said that they consider the cost they pay for health care as a factor in judging quality, less than two-thirds-63%-thought cost information on alternative doctors, hospitals and treatments was very important. And, only 28% thought that the quality of the health care system would be better if they knew the full price of health care services and treatments and prescription drugs, compared to knowing only the cost they paid.

A majority of those surveyed have seen the cost of their health care coverage increase in the past year, through higher premiums (55%), prescription drug copayments or coinsurance (51%), office visit copayments or coinsurance (48%), deductibles (41%), or other out-of-pocket costs (50%). Consequently, the survey reports changes in the way that individuals are using health care. These changes include use of generic drugs (79%), attempts to take better care of oneself (71%), and talking with a doctor more carefully about treatment options and costs (57%). However, some respondents said they have delayed going to a doctor on account of cost concerns (40%) or have limited their doctor visits to when they have more serious symptoms or conditions (54%).

Most Americans remain satisfied with their current health care plan (54% say they are extremely or very satisfied, and 35% are somewhat satisfied), a rating that has remained relatively constant over the eight years that the HCS has been conducted. Generally, satisfaction with health care quality is high, while complaints focus on health care costs. Respondents who saw their costs increase in the past year were more likely to voice dissatisfaction with their current health plan and with other aspects of health care.

The 2005 Health Confidence Survey can be reviewed in full through a link on EBRI's Web site,