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Level of education and patient opinion: significant differences in perceptions of health care.

机译：教育水平和患者意见：对卫生保健的看法有显着差异。

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BACKGROUND: As part of the general competencies set forth by the Accreditation Council for Graduate Medical Education (ACGME), residents must have an understanding of systems-based practice, which is demonstrated by an awareness of-and responsiveness to-the comprehensive health care system. Residents must be able to effectively access and use system resources to provide care that is of optimal value. Essential to understanding and implementing systems-based practice is an awareness of how different patient populations perceive health care; one key factor that influences patients' perceptions of health care is their level of education. METHODS: We surveyed 2900 adult patients in the Cincinnati, Ohio area and stratified them into 2 groups based on their level of education. Group 1 included patients with some high school education or a high school degree. Group 2 included patients with some college education, an undergraduate degree, or graduate/professional-level coursework. We then compared the groups' perceptions of common health care issues, including physician compensation, patient obligation for medical bills, and increased cost for the freedom to choose a physician. RESULTS: Of 395 respondents, a higher percentage of Group 2 patients, compared with those in Group 1, understood that physicians do not collect 100% of what they bill (p < 0.001) and that businesses do influence the amount a physician is paid by insurance companies (p = 0.009). Conversely, a higher percentage of Group 1 patients thought that physicians are overpaid (p = 0.030) and that they keep a large portion of what they charge (p < 0.001). Further, fewer Group 1 respondents felt obligated to pay medical bills not covered by insurance (p = 0.002); they also were less willing to pay more for better medical care (p = 0.002) or for the freedom to choose a physician (p = 0.015). CONCLUSIONS: This study indicates that patients with a lower level of education believe that physicians are overpaid and that they keep a large portion of insurance reimbursement. These findings may explain why fewer patients in this group feel that they are obligated to pay medical bills not covered by insurance and why they are less likely to pay more for better medical care or for the freedom to choose a physician.
机译：背景：作为由研究生医学教育认证委员会（ACGME）制定的一般能力的一部分，居民必须对基于系统的实践有所了解，这体现在对综合医疗体系的了解和响应能力上。居民必须能够有效地访问和使用系统资源，以提供具有最佳价值的护理。了解和实施基于系统的实践的关键是要了解不同的患者群体如何看待医疗保健;影响患者对医疗保健观念的关键因素之一是他们的教育程度。方法：我们对俄亥俄州辛辛那提地区的2900名成年患者进行了调查，并根据他们的教育程度将其分为两组。第一组包括接受过高中教育或高中学位的患者。第二组包括具有一定大学学历，本科学位或研究生/专业水平课程的患者。然后，我们比较了小组对常见医疗保健问题的看法，包括医师补偿，患者承担医疗费用的义务以及选择医师自由的费用增加。结果：在395名受访者中，与第1组相比，第2组患者所占的百分比更高，他们理解医师并未收取其账单的100％（p <0.001），并且企业确实会影响医师所支付的费用保险公司（p = 0.009）。相反，较高比例的第1组患者认为医生多付了费用（p = 0.030），并且他们保留了大部分费用（p <0.001）。此外，第1组受访者认为有义务支付保险未涵盖的医疗费用的情况（p = 0.002）;他们也不太愿意为更好的医疗服务（p = 0.002）或自由选择医生（p = 0.015）付出更多。结论：该研究表明，受教育程度较低的患者认为医生的工资过高，并且他们保留了很大一部分保险费用。这些发现可能解释了为什么该组中的患者较少感到自己有义务支付未包括在保险范围内的医疗费用，以及为什么他们为更好的医疗服务或自由选择医生而支付较少费用的可能性较小。

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