survey of new hampshire physicians on healthcare reform october 2007
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Survey of New Hampshire Physicians on Healthcare Reform October 2007. Survey questions developed by NHMS Task Force with input from UNH Survey Center 2594 surveys distributed 842 e-mailed to physician employees of Dartmouth Hitchcock Clinic by DHC administration - PowerPoint PPT PresentationTRANSCRIPT
Survey of New Hampshire Physicians on Healthcare Reform
October 2007
• Survey questions developed by NHMS Task Force with input from UNH Survey Center
• 2594 surveys distributed – 842 e-mailed to physician employees of Dartmouth
Hitchcock Clinic by DHC administration– 1199 e-mailed by UNH Survey Center to non-DHC
physicians– 553 Mailed to physicians without email information\
• Follow-up to email recipients x 1• Total responses =514 (20% response rate)
Demographics of Respondents
• Gender– 75% Males– 25% Females
• Age– 31% under 45– 57% 46 to 64– 12% 65 and older
• Employment Status– 34% self employed– 34% salaried– 24% DH employee– 9% other
• Specialty– 29% Primary care– 15% Surgery– 25% Specialist– 31% Other
• Practice Size– 13% Solo Practitioners– 22% 2 to 4 Physicians– 25% 5 to 10 Physicians– 20% 11 to 50 Physicians– 19% More Than 50 Physicians
• Party Identification– 53% Democrats– 17% Independent– 29% Republicans
• Member of NH Medical Society– 69% Members– 31% non-members
• Source of survey mailing– 19% survey from DHC– 81% survey from UNH SC
Note: Demographics of responders reasonably reflect NH Physician
Perceptions of CurrentQuality, Cost and Access
In the U.S. Healthcare System
By most measures the quality of healthcare in the U.S. is better than that of most other industrialized nations.
58.3
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31.3
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The per capita cost of healthcare in the U.S. is about the same as that in other industrialized nations.
4.4 3.66
95.6 96.494.1
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In the ideal healthcare system, basic healthcare would be available to all individuals as part of the social contract,
a right similar to basic education, police and fire protection.
81
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Locus of Responsibility for Healthcare
in the Ideal System
In the ideal healthcare system, basic healthcare would be available to all individuals as part of the social contract,
a right similar to basic education, police and fire protection.
81
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In the ideal healthcare system, employers would be responsible for providing health insurance for their employees.
33.130.2
36.4
66.969.8
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In the ideal healthcare system, individuals would be responsible for purchasing health insurance that meets their personal and family needs.
47.8
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Role of the Public Sector
The U.S. healthcare system would benefit from planning of services and infrastructure to match demonstrated need.
93 93.9 92.2
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I would favor a simplified payor system in which public funds, collected through taxes, were used to pay directly for services
to meet the basic healthcare needs of all citizens.
66.6
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55.3
33.4
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If public funding of basic healthcare were provided through a simplified payor system, individuals should have the option
to purchase additional insurance and health services.
94.3 92.694.8
5.7 7.45.3
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The government should pay for healthcare only when disability, misfortune or other obstacles make it
impossible for individuals to provide insurance for themselves.
42.8
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52.857.1
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Role of the Private Sector
Insurance companies provide important services that add value to the healthcare system.
27.2
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Competition and profit within the insurance industry drives innovation, quality and/or efficiency in healthcare and
must be preserved in the US healthcare system.
20.3
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The free-market is the best way to create a high quality, equitable, affordable and accessible healthcare system in the United States.
33.7
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Universal access to healthcare is best achieved by making private insurance more affordable through mechanisms such as tax credits, expanding eligibility
for public programs and/or other incremental changes.
50
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Cost Controls
Denying or limiting access to needed and effective medical care (in non-futile situations) in order to preserve profitability is unethical.
91.8 90.694.2
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Denial of insurance to those with pre-existing conditions is an appropriate means of controlling costs.
3.61.4
3.3
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Control of healthcare costs ultimately must include some limits on availability of services on demand.
87.7 87.2 87.1
12.3 12.8 12.9
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Our society should decide through a democratic process what services should be provided as part of basic healthcare and what services denied.
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Medical Practice Issues
Putting aside paperwork and administrative issues, I find the practice of medicine deeply satisfying.
88.485.5
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Paperwork and administrative issues interfere with my ability to serve patients well.
86.588.7 87.7
13.511.2 12.4
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The financial reimbursement that I receive for the services I provide to patients is fair when compared to other physicians.
44.1
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The financial reimbursement that I receive for the services I provide to patients is fair when compared to other professionals outside of healthcare.
29.933.4
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There should be greater equity in reimbursement of different medical/surgical specialties for equal time spent in providing care to patients.
76.7
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59.7
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Procedures (surgery, high tech interventions/studies etc) require more skill, training and/or engender greater liability than evaluation and management of
patients; reimbursement should reflect this.
61.3
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78.2
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I would be willing to accept a somewhat lower income as a physician in order for all people to access quality healthcare through a simplified planned healthcare system.
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Health outcomes are improved when patients receive coordinated care of chronic illness in a primary care medical home.
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Chronic illnesses are best managed primarily by specialists who see large volumes of the same condition and therefor have specialized skill and
expertise.
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Health Determinants
The health of indiviudals can be enormously affected by their personal behaviors and choices.
98.6 99.3 98.5
1.4 0.7 1.50
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Psychosocial and socioeconomic factors are important contributors to health status in the U.S.
97.7 98.695.7
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Biogenetic heritage and physical health factors in the environment (infectious, traumatic etc) are the major determinants of health in the U.S.
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