2011 Survey of Health Care Consumers in the United States
Global survey of health care consumers
Since 2008, the Deloitte Center for Health Solutions has surveyed U.S. adults to gauge opinions and expectations about our health care system. During this period, the economy tumbled and health care reform became a dominant political theme.
The survey suggests consumers remain largely confused about the system although highly opinionated about their interactions with doctors, hospitals, health insurers, and in their views of prescription drugs. As a result, it is our conclusion that consumers judge the U.S. health care system based on prior personal experience rather than a systemic view, perhaps due to its magnitude and complexity.
Among survey key findings:
- Consumers perceive a complex, wasteful system, sensing a lack of value for what is spent.
- Satisfaction with the U.S. health care system is low; 8 in 10 consumers see no system improvement and 3 in 4 believe other countries' systems are better.
- The cost of health care, coupled with the state of the economy, is of growing concern to consumers, prompting many to alter household spending, delay care, and worry about their ability to pay for future health care costs.
- The majority of consumers report accessing preventive care services - use is higher among consumers with chronic conditions, lower among the uninsured.
- Participation in self-care programs that enhance wellness is relatively low, but use of vitamins and healthier food choices is high.
- Online resources play an increasingly important role in providing information to consumers.
- The most trusted sources of information about treatment effectiveness and costs are doctors and hospitals; manufacturers, employers, insurers, and government agencies are less trusted.
- Interest in using electronic health technologies for coordinated care with physicians or self-monitoring is high.
- Use of personal health records is low but the majority of consumers see their value.
- Consumers use the traditional health care system heavily.
- 8 in 10 consumers have a primary care provider and the majority is satisfied with the quality of care.
- Poor quality of both care and service, as well as cost and insurance changes, prompt decisions to switch doctors.
- The primary reason for hospital selection is insurance coverage; the hospital's reputation and perceived level of specialization are also important.
- Satisfaction with hospital care is high, although lower for ER usage.
- Consumers are receptive to retail clinic use for minor medical problems.
- 40 percent of consumers would leave their local community for health care services elsewhere.
- 57 percent of adult consumers use prescription medications; 68 percent use over-the-counter vitamins or minerals.
- Generic drugs are sought by 1 in 3 consumers in lieu of a prescription medication.
- Confidence in drug efficacy and effectiveness is strong, but 1 in 5 medication users reports switching.
- 1 in 5 consumers integrates alternative therapies with conventional care.
- 2 in 5 consumers look for coverage for alternative therapies when selecting a health plan.
- Employment and affordability are key factors determining insurance status.
- Access to insurance is high: nearly 9 in 10 report some form of coverage.
- The importance of an insurance benefit is increasing among consumers who have employer-sponsored coverage.
- Most with coverage believe it adequately covers their risk, although confidence, understanding, and satisfaction have slipped from prior years.
- Consumers do not believe their health plan choices are wide or varied.
- 1 in 9 insured consumers says they switched plans last year and 3 percent of all consumers say they dropped coverage altogether.
- Consumers recognize that the U.S. health care system has the latest technologies, but poor access and service, and lack of focus on wellness and patient-centered care, are its greatest weaknesses.
- Consumers want reform efforts to address costs, quality, and access; they acknowledge that tradeoffs are necessary and hold mixed views on privatization as an approach.