Evidence map›Paper›PMID 28875447›Full record

Trial reportJournal of general internal medicine2017

Public Mistrust of the U.S. Health Care System's Profit Motives: Mixed-Methods Results from a Randomized Controlled Trial.

Jennifer Richmond, Wizdom Powell, Maureen Maurer, Rikki Mangrum, Marthe R Gold, Ela Pathak-Sen, Manshu Yang, Kristin L Carman

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of general internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jennifer RichmondDomestic Research and Evaluation, American Institutes for Research, Chapel Hill, NC, USA. jrichmond@air.org.
Wizdom PowellDepartment of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA.
Maureen MaurerDomestic Research and Evaluation, American Institutes for Research, Chapel Hill, NC, USA.
Rikki MangrumDomestic Research and Evaluation, American Institutes for Research, Chapel Hill, NC, USA.
Marthe R GoldNew York Academy of Medicine, New York, NY, USA.
Ela Pathak-SenCommotion, Painswick Stroud, UK.
Manshu YangDomestic Research and Evaluation, American Institutes for Research, Chapel Hill, NC, USA.
Kristin L CarmanPatient-Centered Outcomes Research Institute, Washington, DC, USA.

Funding

Neighborhoods, daily stress, affect regulation, & Black male substance useK01DA032611 · NIDA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI POWELL, WIZDOM A · 2014 to 2018
$825k
NIDA NIH HHS K01 DA032611NIMHD NIH HHS L60 MD010134
6 · The paper itself

Abstract

backgroundDecision makers are increasingly tasked with reducing health care costs, but the public may be mistrustful of these efforts. Public deliberation helps gather input on these types of issues by convening a group of diverse individuals to learn about and discuss values-based dilemmas.

objectiveTo explore public perceptions of health care costs and how they intersect with medical mistrust. DESIGN AND

participantsThis mixed-methods study analyzed data from a randomized controlled trial including four public deliberation groups (n = 96) and a control group (n = 348) comprising English-speaking adults aged 18 years and older. Data were collected in 2012 in four U.S. regions. APPROACH: We used data from four survey items to compare attitude shifts about costs among participants in deliberation groups to participants in the control group. We qualitatively analyzed deliberation transcripts to identify themes related to attitude shifts and to provide context for quantitative results about attitude shifts. KEY

resultsDeliberation participants were significantly more likely than control group participants to agree that doctors and patients should consider cost when making treatment decisions (β = 0.59; p < 0.01) and that people should consider the effect on group premiums when making treatment decisions (β = 0.48; p < 0.01). Qualitatively, participants mistrusted the health care system's profit motives (e.g., that systems prioritize making money over patient needs); however, after grappling with patient/doctor autonomy and learning about and examining their own views related to costs during the process of deliberation, they largely concluded that payers have the right to set some boundaries to curb costs.

conclusionsIndividuals who are informed about costs may be receptive to boundaries that reduce societal health care costs, despite their mistrust of the health care system's profit motives, especially if decision makers communicate their rationale in a transparent manner. Future work should aim to develop transparent policies and practices that earn public trust.

Indexed as

Attitude to HealthPublic OpinionAgedClinical Decision-MakingCommunity ParticipationComparative Effectiveness ResearchDecision MakingDelivery of Health CareFemaleHealth Care CostsHealth Services ResearchHumansMaleMiddle AgedMotivationSocioeconomic Factorscomparative effectivenessdecision-makinghealth care costshealth services researchpatient engagement

Identifiers

PMID28875447
PMCPMC5698226

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.