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THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE? Manuel García-Goñi (Universidad Complutense de Madrid, e-mail: mggoni@ccee.ucm.es) Paul Windrum (MMUBS, e-mail: p.windrum@mmu.ac.uk)
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  INTRODUCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  INTRODUCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  Educational programs and information used by patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  Educational programs and information used by patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  THE MODEL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  THE MODEL ,[object Object],[object Object],[object Object],[object Object]
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  THE MODEL ,[object Object],The first order condition is provided by: And here we can solve for:  .
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  THE MODEL ,[object Object],The first order condition is provided by: . From the first order condition we obtain: From the first order condition we obtain: Now, it is interesting to solve this foc taking into account the assumptions given in each of the educational programs
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  THE MODEL ,[object Object],[object Object],[object Object],I i I* TM Figure 1: optimal Choice of information level under the TM model
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  THE MODEL Scenario 2: Patient-Centred Model Let us divide equation 7, from the first order condition into two parts:  and  Under the PC model, and from the first order condition in equation 7 we cannot ignore the first part of the equation as we did under the TM model because now  . Lets manipulate the terms to show that: And from here we solve for  I* PC . Result 1:  The optimal level of information provided to individuals is greater under the PC model than under the TM model.
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  THE MODEL I I* TM Figure 2: optimal Choice of information level under the PC compared to the TM model I* PC i
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  THE MODEL Result 2: Optimal level of information is greater for chronic patients than for acute patients when the PC model is used. I Figure 3: Optimal choice of information level under PC for chronic and acute patients i
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  THE CASE STUDY ,[object Object],[object Object],5% 4% 4% 13% 26% 20% Drop out rate 61/64 = 95% 50/52 = 96% 111/116 = 96% 47/54 = 87% 48/65 = 74% 95/119 = 80% Proportion 61 50 111 47 48 95 # patients who complete the course 64/96 = 67% 52/88 = 59% 116/184 = 63% 54/103 = 52% 65/141 = 46% 119/244 = 49% Proportion 64 52 116 54 65 119 # patients who attend 1 st  session 96 88 184 103 141 244 # patients contacted with appointment Women Men  Total Women Men  Total   Traditional Program Patient Centred Program
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  ESTIMATION METHODS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],β 3   Β 2 β 2  + β 3   Difference β 1  + β 3 β 0  + β 2   β 0  + β 1  + β 2  + β 3 After the education program β 1   β 0   β 0  + β 1   Before the education program Difference Control group "Traditional program" Treatment group "Patient Centred program"
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  RESULTS ,[object Object],[object Object],  0,3922 R-squared       362 N 0,203 -1,28 0,0282 -0,0361 Constant 0,874 0,16 0,0313 0,0050 Older than 65 0,042 2,04 0,0302 0,0618 Sex 0,003 2,97 0,0857 0,2545 PC Model * After Change 0,000 5,29 0,0592 0,3131 After Change 0,926 -0,09 0,0042 -0,0004 PC Model           P>|t| T Std.Err. Coefficient Dependent Variable: Knowledge of Symptoms
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  RESULTS Dependent variables: 2)  Need:  HbA1c blood test : PC MODEL DECREASES THE NEED OF HEALTH SERVICES   0,0778 R-squared       410 N 0,000 84,32 0,0242 2,0395 Constant 0,468 -0,73 0,0206 -0,0150 Older than 65 0,737 -0,34 0,0200 -0,0067 Sex 0,030 -2,19 0,0218 -0,0477 PC Model * After Change 0,000 -4,04 0,0162 -0,0653 After Change 0,926 0,09 0,0267 0,0025 PC Model           P>|t| t Std.Err. Coefficient Dependent Variable:  log of HbA1c blood test
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  RESULTS Dependent variables: 3)  Preferences:  : “ How often have you looked at the learning materials provided on your education program ?”  PATIENTS PREFER THE PC MODEL TO THE TM MODEL   0,4116 R-squared       368 N 0,387 -0,87 0,1775 -0,1537 Constant 0,141 1,48 0,2152 0,3179 Older than 65 0,626 -0,49 0,2520 -0,1231 Sex 0,002 3,14 0,6743 2,1139 PC Model * After Change 0,000 12,44 0,2184 2,7172 After Change 0,686 0,40 0,0217 0,0088 PC Model           P>|t| T Std.Err. Coefficient Dependent Variable:  How often look at materials
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  RESULTS Dependent variables: 4)  Preferences:  How useful has the Salford Community Diabetes Team been?  PATIENTS PREFER THE PC MODEL TO THE TM MODEL   0,8353 R-squared       361 N 0,500 0,68 0,0652 0,0441 Constant 0,964 -0,05 0,0881 -0,0040 Older than 65 0,344 -0,95 0,0826 -0,0782 Sex 0,075 1,79 0,2358 0,4224 PC Model * After Change 0,000 20,41 0,1684 3,4366 After Change 0,919 0,10 0,0055 0,0006 PC Model           P>|t| t Std.Err. Coefficient Dependent Variable:  useful of educational team
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  RESULTS Dependent variables: 5)  Self confidence to see long run effect: PATIENTS UNDER THE PC MODEL PRESENT A GREATER LEVEL OF SELF CONFIDENCE AND THEREFORE IN THE LONG RUN IT IS EXPECTED A GREATER EFFECT IN LIFESTYLES AND THUS IN NEED OF HEALTH SERVICES    0,1857 R-squared       363 N 0,493 -0,69 0,0183 -0,0126 Constant 0,061 1,88 0,0211 0,0397 Older than 65 0,238 -1,18 0,0236 -0,0279 Sex 0,008 2,67 0,0676 0,1805 PC Model * After Change 0,013 2,51 0,0370 0,0927 After Change 0,694 0,39 0,0030 0,0012 PC Model           P>|t| t Std.Err. Coefficient Dependent Variable:  self-confidence
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  CONCLUSIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?:  THANK YOU! THANK YOU VERY MUCH!!!! Any comment: [email_address]

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Manuel García Goñi

  • 1. THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE? Manuel García-Goñi (Universidad Complutense de Madrid, e-mail: mggoni@ccee.ucm.es) Paul Windrum (MMUBS, e-mail: p.windrum@mmu.ac.uk)
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12. THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?: THE MODEL Scenario 2: Patient-Centred Model Let us divide equation 7, from the first order condition into two parts: and Under the PC model, and from the first order condition in equation 7 we cannot ignore the first part of the equation as we did under the TM model because now . Lets manipulate the terms to show that: And from here we solve for I* PC . Result 1: The optimal level of information provided to individuals is greater under the PC model than under the TM model.
  • 13. THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?: THE MODEL I I* TM Figure 2: optimal Choice of information level under the PC compared to the TM model I* PC i
  • 14. THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?: THE MODEL Result 2: Optimal level of information is greater for chronic patients than for acute patients when the PC model is used. I Figure 3: Optimal choice of information level under PC for chronic and acute patients i
  • 15.
  • 16.
  • 17.
  • 18. THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?: RESULTS Dependent variables: 2) Need: HbA1c blood test : PC MODEL DECREASES THE NEED OF HEALTH SERVICES   0,0778 R-squared       410 N 0,000 84,32 0,0242 2,0395 Constant 0,468 -0,73 0,0206 -0,0150 Older than 65 0,737 -0,34 0,0200 -0,0067 Sex 0,030 -2,19 0,0218 -0,0477 PC Model * After Change 0,000 -4,04 0,0162 -0,0653 After Change 0,926 0,09 0,0267 0,0025 PC Model           P>|t| t Std.Err. Coefficient Dependent Variable: log of HbA1c blood test
  • 19. THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?: RESULTS Dependent variables: 3) Preferences: : “ How often have you looked at the learning materials provided on your education program ?” PATIENTS PREFER THE PC MODEL TO THE TM MODEL   0,4116 R-squared       368 N 0,387 -0,87 0,1775 -0,1537 Constant 0,141 1,48 0,2152 0,3179 Older than 65 0,626 -0,49 0,2520 -0,1231 Sex 0,002 3,14 0,6743 2,1139 PC Model * After Change 0,000 12,44 0,2184 2,7172 After Change 0,686 0,40 0,0217 0,0088 PC Model           P>|t| T Std.Err. Coefficient Dependent Variable: How often look at materials
  • 20. THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?: RESULTS Dependent variables: 4) Preferences: How useful has the Salford Community Diabetes Team been? PATIENTS PREFER THE PC MODEL TO THE TM MODEL   0,8353 R-squared       361 N 0,500 0,68 0,0652 0,0441 Constant 0,964 -0,05 0,0881 -0,0040 Older than 65 0,344 -0,95 0,0826 -0,0782 Sex 0,075 1,79 0,2358 0,4224 PC Model * After Change 0,000 20,41 0,1684 3,4366 After Change 0,919 0,10 0,0055 0,0006 PC Model           P>|t| t Std.Err. Coefficient Dependent Variable: useful of educational team
  • 21. THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?: RESULTS Dependent variables: 5) Self confidence to see long run effect: PATIENTS UNDER THE PC MODEL PRESENT A GREATER LEVEL OF SELF CONFIDENCE AND THEREFORE IN THE LONG RUN IT IS EXPECTED A GREATER EFFECT IN LIFESTYLES AND THUS IN NEED OF HEALTH SERVICES   0,1857 R-squared       363 N 0,493 -0,69 0,0183 -0,0126 Constant 0,061 1,88 0,0211 0,0397 Older than 65 0,238 -1,18 0,0236 -0,0279 Sex 0,008 2,67 0,0676 0,1805 PC Model * After Change 0,013 2,51 0,0370 0,0927 After Change 0,694 0,39 0,0030 0,0012 PC Model           P>|t| t Std.Err. Coefficient Dependent Variable: self-confidence
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  • 23. THE EFFECT OF INFORMATION IN THE PROVISION OF HEALTH CARE. IS INFORMATION EQUALLY USEFUL FOR EVERYONE?: THANK YOU! THANK YOU VERY MUCH!!!! Any comment: [email_address]