Welcome to Center for Advancing Health

As the term "health care consumer" gains traction, I have been thinking about the skills we are assumed to possess as Americans who regularly buy stuff -- skills that many employers and benefits consultants believe can be easily applied to decisions about purchasing health care services, tests  and drugs.

Think about it: to be an effective, engaged health care consumer in the U.S. today means that many of us must find and make use of information that enables us to:

• choose the most appropriate health plan for our family
• select the best and cheapest radiology practice or laboratory
• identify the Part D pharmacy benefit plan that meets our needs this year
• make cost, quality and safety trade-offs for the hospital we patronize
• manage our employer's offer of a health savings account combined with catastrophic insurance coverage

At least three skill sets are necessary to make good decisions on such matters. First, we must understand our own personal risks and make a rough prediction of our future health needs based on those probabilities.  Second, we must conduct the research to weigh the cost and quality trade-offs for health plans, services, tests and drugs consistent with our current and future needs.  And third, we need some financial management skills to ensure prudent spending – and saving – of our resources over time.

This is a tall order, especially for a population that generally shows little awareness of   the (1) uncertainty of medical diagnoses, (2) possibility of multiple approaches to treat the same disease, (3) variations in quality of care at different hospitals and by different physicians and (4) likelihood of medical errors, despite considerable media exposure to these issues. 

To our fuzziness about the serious stakes of our consumer decisions about health care, add our documented discomfort with numbers and robust inability to personalize risk (lottery tickets, anyone?).  And our poor record in saving now for future needs and aversion to reading the small print related to financial transactions is demonstrated vividly in our overuse of credit cards and appetite for subprime mortgages.

Are we up to the challenge? 

Well, some of us are and many of us are not.  The problem is that those of us who will fall short on making wise, informed decisions as health care consumers are disproportionately those of us who are already disadvantaged by illness, limited literacy and numeracy, and constrained resources.

The solution is not to eliminate the need to make these decisions.  But in the rush to harness our power as consumers of health care services, we would be well served to reflect on recent 401(k) losses, foreclosures and predatory lending practices as warnings of how encouraging consumers to take responsibilities beyond their capacities can do real harm.

The Health Behavior News Service regularly distributes stories summarizing new research on health behavior issues. These stories can be found online at http://www.cfah.org/hbns/news/index.cfm.

Here are some stories released in November:

Message to Reduce Risky Sexual Activity Reaches Across All Teens
Interventions aimed at reducing sexual activity appear to be similarly effective in high-risk and low-risk teens, a new study finds. No matter where they fell on the risk spectrum, teens seemed positively influenced by intervention messages in the 1990s and early 2000s, when there was a decline in sexual experience and number of sexual partners across the board.

Electronic Health Records Could Reduce Malpractice, Study Hints  
A new study provides limited evidence that physicians could make fewer mistakes on the job by abandoning paper-based medicine in favor of electronic health records.  The findings aren't definitive. Still, they "suggest that electronic health records may prevent medical errors and malpractice claims," said co-author Steven Simon, M.D., an internist at Harvard Medical School. 

Doctors Hesitate to Discuss Fertility Preservation With Cancer Patients
Although some teenagers and young adults become infertile following cancer treatment, physicians are hesitant to discuss options to preserve fertility with patients, according to a new Florida study. Yet the American Society of Clinical Oncologists recommends that the discussion take place "at the earliest possible opportunity."

Younger Alcoholic Men at Risk for Osteoporosis, Small Study Finds
A new study shows that younger male alcoholics are at increased risk for osteoporosis. People with osteoporosis, no matter what the cause, are at more risk for fractures and poor fracture healing.
 
Doctors Often Skip Health Behavior Conversations With Teens
Although national health guidelines call for physicians to discuss topics such as substance use, safety and nutrition with adolescents, new research suggests that these talks do not occur as often as they should.

Self-Weighing Could Help Teens Achieve Healthy Weight Control
Overweight teens who weigh themselves at least once a week are more likely to engage in other healthy weight control measures than teens who step on the scale less frequently, according to a new small study. The results might allay concerns that recommending the behavior could backfire with teens who struggle with obesity.