Engaged consumers often use more health resources, but heavy users of health care services are not necessarily engaged. Consumers often self-describe themselves as “engaged” in their healthcare if they are a heavy user of health care services, but the truly engaged consumers understand it is more than simple usage that defines their level of health care engagement.
DSS has been measuring engagement through its Health Care Engagement Index (HCEI)™ for more than two years. The HCEI computes each individual’s level of engagement based on an array of questions related to health literacy, knowledge, attitudes and behaviors related to their overall health care. The HCEI has been proven in numerous studies to be highly correlated with usage of preventive care, management of existing health conditions and other positive consumer behaviors.
We have also experimented with a number of direct questions that ask consumers whether they think they are “engaged” or not. These questions are primarily correlated with current health care usage, but not with long-term behaviors, attitudes and knowledge regarding appropriate care. The heaviest health care users are more likely to say they are engaged while less frequent users are much less likely to do so. The direct question approach does not distinguish between those who avoid and misuse available resources versus those who are healthy and not in need of them at this time. Those who use more health care services are more likely to describe themselves as “engaged”, but they are not more knowledgeable than the typical consumer and do not use health care services more efficiently and more effectively. However, those identified by DSS’s HCEI as more engaged are more knowledgeable and better able to make decisions for themselves regarding their health care needs. They are also much more likely to use appropriate preventive care services and maintain maximum control of any chronic diseases or conditions they experience.
In focus groups, we asked consumers how they define an “engaged health care consumer.” Some of the best responses are shown below:
Finally, one consumer summed up her motivation for being an “engaged health care consumer” as:
I believe that I am very heavily engaged and take the position that as a consumer, I have rights and demands that must be addressed. If I hire a plumber to fix a leak and it still leaks, I demand he get it done right. I take the same approach to health care. I will not accept poor medical service and will “raise hell” until it gets done right. There is nothing more important to me than my health, so I have a huge incentive to monitor and control the care that I receive.