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Does providing consumer health information affect self-reported medical utilization? Evidence from the Healthwise
T H Wagner1, J H Hibbard, M R Greenlick
1VA HSR&D Health Economics Resource Center, Center for Primary Care and Outcomes Research, and Center for Health Policy, Stanford University, CA, USA. twagner@stanford.edu
Objective:
To determine whether providing health information to residents of Boise ID had an effect on their self-reported medical utilization.
Research Design:
The Healthwise Communities Project (HCP) evaluation followed a quasi-experimental design.
Subjects:
Random households in metropolitan zip codes were mailed questionnaires before and after the HCP. A total of 5,909 surveys were returned.
Measures:
The dependent variable was self-reported number of visits to the doctor in the past year. A difference-in-differences estimator was used to assess the intervention's community-level effect. We also assessed the intervention's effect on the variance of self-report utilization.
Results:
Boise residents had a higher adjusted odds of entering care (OR = 1.27, 95% CI 0.88, 1.85) and 0.1 more doctor visits compared with residents in the control cities; however, for both outcomes, the effects were small and not significant. Although the means changed little, the data suggest that the variance of utilization in Boise decreased.
Conclusions:
The HCP had a small effect on overall self-reported utilization. Although the findings were not statistically significant, a posthoc power analysis revealed that the study was underpowered to detect effects of this magnitude. It may be possible to achieve larger effects by enrolling motivated people into a clinical trial. However, these data suggest that population-based efforts to provide health information have a small effect on self-reported utilization.
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