Focus Group Summary for Utah Hospital Comparison Report for Heart Surgeries and Conditions for Years 2002-2004

Focus Group Summary – 02/15/06
Mount Olympus Senior Center

Moderator: Christie North
OHCS staff: Carol Masheter and Mike Martin
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Nine people in attendance – 5 women, 4 men – all senior citizens.

All nine filled out the informational form – results to be published later.

All nine agreed to have the session recorded.
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Take a look at the cover page, does it look appealing to you?

-No, it looks like it’s put out by a hospital. A hospital would be biased.
-Cover says who created the report, right here!
-Still can’t easily tell who published it. PRIORITY
-It compares hospitals, PERIOD. Which is the safest?
-I’d give it to my wife to read.

Look through the first few pages, would do they tell you about the report?

-Legislature wants this done.
-I would like more explanation of SB 132.
-We’ve needed this type of report for a long time! (2 people agree)
-I don’t know what the Health Data Authority is. Can we trust them? PRIORITY
-Remember, we (seniors) are cynical. Medicare has given us the shaft!
-This will give us some good information.
-Physician tells you where to go!
-But now we are more empowered and have tools to compare!

Look at the Table of Contents, does it make sense to you?

-Yes, it makes sense.
-Yes.
-Yes.
-It makes sense. PRIORITY
-Will it include the new IHC Hospital?
-That hospital is too new for this report!
-Is this going to be updated yearly?
-Quality and safety are most important to us.

Look at Page 3, what do you think about the page?
Do you like the colors?

-Yes.
-Yes.
-I like blue better. (three people agreed) PRIORITY

Easy to read?

-Yes (all)

Print OK?

-Yes (all)

-What does the O/E ratio mean? (many in agreement) PRIORITY

Note: Long discussion ensued, the O/E ratio was front and center.

Now look at your handout, what do you think of these tables as an alternative?

-Much better. (several in agreement) PRIORITY
-Says more than the other one.
-Columns give more info.
-Doesn’t help me.
-We don’t need all that info.
-Just tell me who is good and who is bad.
-What is CABG?
-What are the national rates?
-I just want to know Utah rates, not national. (two in agreement)
-I like the “Notes About the Table” – please include so I can understand better.
-Lots of people don’t read, they just look at the graphs.

Now look at Page 13 (charges table), is this information useful to you?

-“Why Is This Important” at bottom of page not good, should be prominent.
-I want to know how much my insurance will cover.
-Well, call them up and ask them!
-On page 12, there is no explanation for “No Complication”
-Where is LOS?
-Yeah, it would be great to know length of stay (several agree)
-Length of stay would help explain the large disparity in charges. PRIORITY
-Can we break this down and separate men and women?
-Men and women might have different charges.
-That wouldn’t matter much (several agree)
-I’m confused about No Complication and With Complication.
-They explain it at the left side of the page.
-OK, it makes sense. I don’t know. I need to read this more.

Look through the rest of the report. Give me your impressions.

-What about doctor information, especially if they have been involved in malpractice.
-I like the definitions. (several agree)
-Percutaneous need to be defined better.
-“Understanding the Tables” needs to be clearer and easier to understand. PRIORITY
-I would pick up this report (several others agree)
-Why is there such a large disparity in charges?
-You need to report length of stay.

Now look at the glossary. Is this helpful to you?

-I like it.
-Adjusted rate is good. (several agree)
-Adjusted rate definition is not helpful, too much information.
-National averages mean nothing to me, we live in Utah!
-National averages would not be helpful. (several agree) PRIORITY
-You need to define IQI earlier in the report. PRIORITY
-You need to define some of these terms earlier in the report.
-Glossary makes sense to me, they are probably going to fill it in more later.

Now look the hospital list. Is this useful to you?

-Yes!
-Yes.
-This is useful. (several nods in agreement)
-Can you break out the bed size into cardiac beds? PRIORITY
-You should print both – total beds and total beds available for cardiac patients.
-Address and phone number are very useful.
-You should put this list near the front of the report. (several agree) PRIORITY

Would you go to the Internet to view this report?

-No.
-No. (2 said yes, 7 said no)
-I think 50% of us seniors would, but 50% would not.
-I would go to the National Library of Medicine.

Would you share this report with your family?

-Yes.
-Yes.
-Absolutely. (all said they would)
-I would want to take it home. Just having it in a doctor’s office is not good enough.
-I want it and would pay a few dollars for it.
-You need this in hard copy for us, not on the Internet. PRIORITY
-You should have this posted on other health-related sites.
-Our families need this report so they know what to do. (several agree) PRIORITY
-This will help us to ask questions when we see our doctor.
-Families need it.
-If you like your MD, you won’t make any changes. (several disagree)
-I would change, even if my doctor told me not to. I take charge of myself.

Now look at the two consumer pages, do you find them useful?

-Very good. (nods in agreement)
-Quite good, especially “Become An Informed Healthcare Consumer”
-I also like “Ask Questions of Your Doctor” and “Avoid Unnecessary Treatment”
-You should encourage people to write down their questions before seeing a doctor.
-Maybe add a tear-off form that people use for their questions. PRIORITY
-I’d like to know what would happen if I didn’t have surgery.

<Informal discussion followed. End of focus group. 60 minutes duration.>
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Priorities Listed Above

-Still can’t easily tell who published it.
-I don’t know what the Health Data Authority is. Can we trust them?
-It makes sense. (Table of Contents)
-I like blue better. (three people agreed)
-What does the O/E ratio mean? (many in agreement)
-Much better. (several in agreement – the five column mortality table)
-Length of stay would help explain the large disparity in charges.
-“Understanding the Tables” needs to be clearer and easier to understand.
-National averages would not be helpful. (several agree)
-You need to define IQI earlier in the report.
-Can you break out the bed size into cardiac beds?
-You should put this hospital list near the front of the report. (several agree)
-You need this in hard copy for us, not on the Internet.
-Our families need this report so they know what to do. (several agree)
-Maybe add a tear-off form that people use for asking questions of their doctor.
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Conclusion: Above session was attended by a fairly-educated group of seniors. They engaged in a lively discussion for 60 minutes and provided constructive feedback, both positive and negative. Group was enthusiastic about the report and expressed interest in receiving a hard copy. Emphasis was placed on getting the report to their families as well. Many asked when the report would be published. HDC/OHCS is advised to print enough hard copies to send to senior centers across the state, if it is found that such settings contain a viable target audience. Another “senior center- like” focus group is needed, preferably that will attract lower-income and/or minority residents.