Form 1 Pre-Choice Questionnaire

Form Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX

Attachment D-1

SelectMD 2.0 Consumer Choice Experiment

PRE-CHOICE QUESTIONNAIRE

Public reporting burden for this collection of information is estimated to average 10 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

[PRE-CHOICE SURVEY]

[DISPLAY]

Thank you for agreeing to participate in this study. The purpose of the study is to learn how people choose a doctor as their regular source of medical care and advice. The study is being conducted by researchers at several major universities and research organizations including Yale, University of Wisconsin and RAND.

[DISPLAY]

What You Will Be Asked to Do:

The study has two stages. We’re going to first ask you some questions about your health care experiences and how you go about choosing a physician. That’s coming right up, after you finish this introduction.

The second stage is a little more involved. A week after you have completed this initial survey, you will receive an invitation from GfK to begin the second part of the study. You will log onto the GfK website, just as you have done now, just to verify who you are. You will then be automaticallytransferred toanother website that has information about the doctors available to you. We’ll ask you to use that information to select one doctor who you think would be the best for you and your health needs. You can assume that you would pay the same amount for your medical care, regardless of which doctor you choose. Although you will not really be selecting a doctor, we’d like you to consider this choice as carefully as if you were making it for yourself. Since this is just an exercise; you will not be contacted by the doctor you “choose.”

After you have made your choice of doctor, you will then be automatically transferred back to the GfK website and will then be asked a set of questions about how you made your choice, the usefulness of the information available for that selection, and your confidence in the choice that you made. Please do not log-off after choosing your doctor; these follow-up questions are very important so that we can understand how you made your choice. And please do not begin this study until you have approximately 30 minutes you can spend, since it’s important that you answer questions about your choice right after picking a doctor.

[SP]

Q1. A health care provider is a doctor, nurse practitioner, or physician’s assistant. Have

you ever had to pick a health care provider for your own medical care?

Yes 1

No 2

[SP]

Q2. Information comparing different doctors, hospitals, or health insurance plans is available in different places. For example, it might be given out at work, come to your home by mail, appear in a newspaper or magazine, or be found on an Internet web site.

In the past 12 months, do you remember seeing any information comparing different doctors, hospitals or health plans?

Yes 1

No 2

Not sure 3

[IF Q2=1 OR 3 OR REFUSED, GET Q3a. IF Q2=2 SKIP TO Q6]

[SP]

Q3a. Did you see any information comparing the quality among different doctors in the past 12 months?

Yes 1

No 2

Not sure 3

Q3b. In the past 12 months, have you ever visited an internet website to learn specifically about the quality of doctors in your area?

Yes 1

No 2

Not sure 3

[IF Q3a=2, AND Q3b=2 then SKIP TO Q4]

[MP]

Q3c. Which, if any, of the following specific information comparing the qualityamong different doctors have you seen in the past 12 months?

a. Scores from surveys about patients’ experiences with their doctor

b. Ratings of how well doctors care for particular illnesses

c. Ratings of how well doctors prevent medical errors

d. Patients’ written comments about visits to their doctors

e. Other information comparing doctors: ____________________________[add verbatim]

f. I have not seen any information about doctors [SP]

[SP]

Q4. Did you see any information comparing the quality among different hospitals in the past 12 months?

Yes 1

No 2

Not sure 3

[SP]

Q5. Did you see any information comparing the quality among different health insurance plans in the past 12 months?

Yes 1

No 2

Not sure 3

PROGRAMMERNOTE:For Q6 below, respondents would at first see only the three-item scale at the left (note matter much, matter some, matter a lot). If they identify MORE THAN THREE of these attributes as mattering a lot, they will then have a follow-on screen that will show them ONLY the attributes that they reported to matter a lot  they will be asked to select three that mattered most.

[GRID, SP ACROSS]

Q6.[C1]Patients look for various things in their doctors and medical practices. Below is a list of factors that other patients have said were important to them whenselecting a primary care doctor. Please read through this entire list, and then indicate which would matter to you.

Attributes of Doctor [randomized order]	Not Matter Much	Matter Some	Matter A Lot	One of the Three That Mattered Most
Training [good medical school; board certification]				
Reputation [recommended by others]				
Bedside Manner [warmth, caring, good listener]				
Time Availability [not rushed during visits]				
Patient Complaints [few complaints or malpractice charges]				
Treatment Orientation [how aggressively treats illness]				
Trustworthy [choices on behalf of patient, not insurer]				
Proximity [close to home or work]				
Safety [avoiding medical errors]				
Technical Quality [gives patients best treatments and tests]				
Office Staff [friendly, courteous, helpful]				
Affiliated with Insurance Plan [covered without extra copayments]				

[GRID, SP]

Q7. [T1A] Good health care requires that doctors have a variety of skills, including technical knowledge about treatments, ability to relate to their patients, helping patients select the best treatments and avoiding errors.Based on what you have heard, read or experienced yourself, do you think that doctors who are good at any one of these skills will also be good at the others? Or do some doctors have certain skills, but not so much the others? If you were choosing between the follow pairs of statements, with which do you agree?

A. Doctors who know the technical aspects of treatment are usually not so good relating to their patients			A Bit of Both			Doctors who know technical aspects of medical care are usually also good at relating to their patients
	1	2	3	4	5

B. Doctors who select the best treatments usually are not so good at avoiding medical errors			A Bit of Both			Doctors who can select the best treatments usually are also good at avoiding medical errors
	1	2	3	4	5

[GRID, SP]

Q8. [C2]. Based on what you have heard, read or experienced yourself, do you think that doctors who provide primary care (check-ups, screening for illnesses, referrals to specialsits) are equally good treating all patients, or are some doctors particularly helpful for patients with particular needs or preferences about their medical care? If you were choosing between the follow pairs of statements, with which do you agree?

A. A primary care doctor will be equally good diagnosing and treating all patients, whatever their health problems			A Bit of Both			Primary care doctors are often particularly good with some specific health problems, but not so much others
	1	2	3	4	5

B. When reading comments from patients treated by a primary care doctor, it doesn’t really matter which of them is writing about their care,			A Bit of Both			To really understand patients’ comments about primary care doctors, one has to know what these patients expected from medical care.
	1	2	3	4	5

[DISPLAY]

The following questions are about your health.We will not report your individual responses, only summaries of responses of the people participating in this survey

[SP]

Q9. In general, how would you rate your overall health?

Excellent 1

Very good 2

Good 3

Fair 4

Poor 5

[SP]

Q10. In the last 12 months:

Yes	No	Don’t know
1	2	3

	Have you been treated for a serious or life-threatening health condition?
	Have you had some other long-term medical condition that required regular medical monitoring or treatment?

[SP]

Q11. How many times during the past 12 months did you go to a doctor's office orclinic to get health care for yourself?

None 1

1 2

2 3

3 4

4 5

5 to 9 6

10 or more 7

[GRID, SP ACROSS. RANDOMIZEAND RECORD]

Q12. [A1] We’d like to ask you some questions about how you approach your health care. Please indicate how much you agree or disagree with each of the following statements.

Completely disagree	Somewhat disagree	Neither agree nor disagree	Somewhat agree	Completely agree
1	2	3	4	5

1. I take primary responsibility for managing my own health

2. I am confident that I know when I need health care

3. If I were taking several medications, I would always bring a complete list each time I went for health care

4. I know how to find information about quality of care for doctors and hospitals.

5. I am confident that I can use the information available to me to choose a good health care provider

6. If something went wrong with my health care, I would make an effort to fix the problem.

[DISPLAY]

Thank you for completing the first stage of this study. You will be contacted in a week by GfK, letting you know that the second stage of the study is open for your participation.

Q26. [L4A – Open ended] Was there any information on the website that you found surprising?

 No

 Yes  Please describe what was surprising

Q27 [L4B – open ended]. Was there anything on the website that led you to think differently about how you should go about assessing or selecting a doctor?

 No

 Yes  Please describe what you learned, as if you were describing it to your family or friends so that they could learn from your experiences

Q28. [T2A --Open-ended]Please describe the way in which you went about selecting the doctor whom you chose? First, we’d like to understand your decision in your own words. Imagine that you were describing this to a family member or friend, so that they could learn from your experience.

[MP]

Q29[T2B]Now consider some specific ways in which you might have gone about making your decision. Which of the following describe how you chose a doctor on this website?

[Check all that apply]

Yes	No
1	2

1. I picked the doctor who seemed most likeable to me

2. I focused on the one quality rating that seemed most important to me

3. I searched for a doctor who was good enough, rather than trying to figure out who was the best

4. I tried to take all of the ratings into account

5. I figured out how much each quality rating mattered to me, then chose a doctor based on the ratings that seemed most important

6. None of the above: I went about choosing in a different way [SP]

[Please describe: ___________________________________________________

__________________________________________________________________

__________________________________________________________________]

[GRID, SP ACROSS]

Q30. [D2] Sometimes making sense of reports on quality can just feel too difficult to be worth the effort. Based on the website that you just visited, how much did each of these sources of information matter in selecting the doctor whom you chose?

Sources of Information [randomized]	Only Source That Mattered	One of Several Sources That Were Important	Took Into Account, But Not A Major Influence	Was Too Difficult to Use
Survey of Patient Experience				
Clinical Records on Treatment/Screening				
Practices Promoting Patient Safety				
Comments from Patients (in their own words)				

[GRID, SP ACROSS]

Q31 [D3] If you were to be faced with a choice of primary care clinician in real life and had a choice of websites reporting information about these doctors, which of the following types of information would you look for on a website?

Sources of Information [randomized]	Absolutely Essential	Important, But Not Essential	Useful, But Not Worth the Effort	Not Useful
Survey of Patient Experience				
Clinical Records on Treatment/Screening				
Practices Promoting Patient Safety				
Comments from Patients (in their own words)				

[GRID, SP ACROSS]

Q32. [L2].Good medical care requires that doctors have a variety of skills, including technical knowledge about treatments, ability to relate to their patients, helping patients select the best treatments and avoiding errors.Based on what you have heard, read or experienced yourself, do you think that doctors who are good at any one of these skills will also be good at the others? Or do some doctors have certain skills, but not so much the others? If you were choosing between the follow pairs of statements, with which do you agree?

A. Doctors who know the technical aspects of treatment are usually not so good relating to their patients			A Bit of Both			Doctors who know technical aspects of medical care are usually also good at relating to their patients
	1	2	3	4	5

B. Doctors who select the best treatments usually are not so good at avoiding medical errors			A Bit of Both			Doctors who can select the best treatments usually are also good at avoiding medical errors
	1	2	3	4	5

[GRID, SP ACROSS]

Q33 [L3] Based on what you have heard, read or experienced yourself, do you think that doctors who provide primary care (check-ups, screening for illnesses, referrals to specialists) are equally good treating all patients, or are some doctors particularly helpful for patients with particular needs or preferences about their medical care? If you were choosing between the follow pairs of statements, with which do you agree?

A. A primary care doctor will be equally good diagnosing and treating all patients, whatever their health problems			A Bit of Both			Primary care doctors are often particularly good with some specific health problems, but not so much others
	1	2	3	4	5

B. When reading comments from patients treated by a primary care doctor, it doesn’t really matter which of them is writing about their care,			A Bit of Both			To really understand patients’ comments about primary care doctors, one has to know what these patients expected from medical care.
	1	2	3	4	5

[GRID, SP ACROSS. RANDOMIZE AND RECORD]

Q34 [T3]How much to you agree or disagree with the follow statements about choosing a doctor?

Completely Disagree	Somewhat Disagree	Neither AgreeNor Disagree	Somewhat Agree	Completely Agree
				

1. I would be willing to accept a higher rate of medical errors in a doctor who was warm and caring

2. I would be willing to accept a doctor who had less time to talk to me about my health care needs if they had a good track record for avoiding medical errors.

3. I would be willing to accept a doctor who was less warm and caring if they had plenty of time to talk with me about my medical care.

[GRID, SP ACROSS. RANDOMIZE AND RECORD]

Q35. [A2] We’d like to ask you some questions about how you approach your health care. Please indicate how much you agree or disagree with each of the following statements.

Completely disagree	Somewhat disagree	Neither agree nor disagree	Somewhat agree	Completely agree
1	2	3	4	5

1. I take primary responsibility for managing my own health

2. I am confident that I know when I need health care

3. If I were taking several medications, I would always bring a complete list each time I went for health care

4. I know how to find information about quality of care for doctors and hospitals.

5. I am confident that I can use the information available to me to choose a good health care provider

6. If something went wrong with my health care, I would make an effort to fix the problem.

[GRID, SP ACROSS. RANDOMIZE AND RECORD]

Q36. [E1] Suppose you were choosing between two doctors, one of whom was in your health plan’s network of providers and could be seen at no cost to you. The second doctor was rated higher on quality-reporting websites, but would cost you $50 out-of-pocket for each visit to their office – and you expected to visit the doctor several times each year. How anxious would you feelabout choosing the lower cost doctor if you knew that:

Not At All Anxious	A Little Anxious	Somewhat Anxious	Very Anxious	Extremely Anxious
				

1. This lower-cost doctor was described by his current patients as having little time to talk with them about their health and treatment choices

2. This lower-cost doctor had an above-average number of patients complaining about being treated impersonally

3. This lower cost doctor had made an above-average number of medical errors

[GRID, SP ACROSS]

Q37A. [E2A] If you were choosing among primary care doctors in real life, how anxious would you feel about making the best choice?

Not At All Anxious	A Little Anxious	Somewhat Anxious	Very Anxious	Extremely Anxious
				

[GRID, SP ACROSS]

Q37B[E2B] If you were choosing among primary care doctors in real life for a family member who was seriously ill, how anxious would you feel about making the best choice?

Not At All Anxious	A Little Anxious	Somewhat Anxious	Very Anxious	Extremely Anxious
				

[GRID, SP ACROSS. RANDOMIZE AND RECORD]

Q38.We’d like to ask you some questions about how you usually make decisions in your life. Please indicate how much you agree or disagree with each of the following statements:

Completely disagree	Somewhat disagree	Neither agree nor disagree	Somewhat agree	Completely agree
1	2	3	4	5

a. Whenever I make a choice, I’m curious about what would have happened if I had chosen differently.

b. Whenever I make a choice, I try to get information about how the other alternatives turned out.

c. If I make a choice and it turns out well, I still feel like something of a failure if I find out that the other choice would have turned out better.

d. When I think about how I’m doing in life, I often assess opportunities I have passed up.

e. Once I make a decision, I don’t look back.

f. When I watch TV, I channel search, often scanning through the available options even while attempting to watch one program.

g. While I am in the car listening to the radio, I often check other stations to see if something better is playing, even if I’m relatively satisfied with what I’m listening to.

h. Renting movies is really difficult. I’m always struggling to pick the best one.

i. No matter what I do, I have the highest standards for myself.

j. I never settle for second best.

k. When making decisions, I rely on my instincts.

l. I often need the assistance of other people when making important decisions.

m. I avoid making important decisions until the pressure is on.

n. I make decisions in a logical and systematic way.

o. I rarely make important decisions without consulting other people.

p. My decision-making requires careful thought.

q. When I make a decision, I trust my inner feelings and reactions.

r. I often procrastinate when it comes to making important decisions.

s. I use the advice of other people in making my important decisions.

[PROGRAMMER NOTE: Show the table for all questions Q30a-d. SHOW GRIDLINES]

[SP]

Q39a. Finally, we’d like to learn more about how you make decisions about consumer products. The information below represents a choice among DVD players. The ratings run from 1=Very Low to 3= Average to 5=Very High, with a higher number signifying better product performance.

			Features
DVD Brand	Picture Quality	Sound Quality	Programming Options	Reliability of Brand	Price
A	2	5	5	1	$199
B	1	2	5	2	$199
C	5	5	4	2	$199
D	3	3	5	3	$199
E	2	5	2	4	$199

If one of your friends told you that he wanted to buy the most reliable DVD of this bunch, which would you recommend that he select?

Brand A 1

Brand B 2

Brand C 3

Brand D 4

Brand E 5

[SP]

Q39b. If another friend told you that she wanted to buy a DVD with the very highest sound quality and, among those with the best sound, the one with the best programming options, which would you recommend that she select?

Brand A 1

Brand B 2

Brand C 3

Brand D 4

Brand E 5

[SP]

Q39c. If a different friend told you that he cared about all these features equally and wanted to buy the DVD that had the best scores overall, which would you suggest that he select?

Brand A 1

Brand B 2

Brand C 3

Brand D 4

Brand E 5

[SP]

Q39d. If one other friend told you that she wanted a DVD that scored no worse than average on every feature, which would you advise her to select?

Brand A 1

Brand B 2

Brand C 3

Brand D 4

Brand E 5