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Tuesday, 17 October 2006


Ellen Peters, Ph.D.1, Nathan Dieckmann2, Anna Dixon, M.Sc.Econ2, Judith H. Hibbard, Dr.P.H.2, and C.K. Mertz, MS1. (1) Decision Research, Eugene, OR, (2) University of Oregon, Eugene, OR

In three experimental studies, we examine whether information presentation methods differentially influence consumers who differ in numeric skills. We assessed how well those at different numeracy levels understood the information provided and how well they were able to use that information in choice.

A convenience sample (N=303) of employed-age adults stratified on education chose between hospitals and completed comprehension questions in three studies. Results support the idea that "Less is more" when presenting consumers with comparative performance information to make hospital choices. In Study 1, when given less information, consumers were better able to comprehend important cost and quality information, and they were more likely to choose a higher quality hospital. In Study 2, making only the more important measure easier to evaluate led to more choices of higher quality hospitals. Finally, in Study 3, less cognitive effort was more; presenting information in a “higher is better” frame that is consistent with how individuals think about and process numbers facilitated comprehension and helped consumers to make better hospital choices. Results were particularly strong for those lower in numeracy who had higher comprehension and made better choices when the information-presentation format was designed to ease the cognitive burden and highlight the meaning of important information.

Understanding written materials that describe hospital quality is difficult for consumers, particularly those who are low in numeric skills. Since a significant portion of the population is low in numeracy, this is of concern. Choosing a hospital with little understanding of what one is choosing may lead to dissatisfaction and possibly serious health and financial consequences for the individual. The findings have important implications for the sponsors of comparative quality reports designed to inform consumer decision making in health care.

See more of Poster Session IV
See more of The 28th Annual Meeting of the Society for Medical Decision Making (October 15-18, 2006)