This focus group was conducted Thursday, September 15, 2005, 9:00 PM. This was a prenatal class held at Cottonwood Hospital. There were five women and 4 men. The process was explained and the group agreed to have the session recorded.
Man: Yes
Man: If my insurance company did not pick where I went.
Man: Yes
Others nod.
Man: Yes, I am interested in hospital charges. I think everyone is.
Woman: I think that the picture catches my eye a little bit. I would look at the picture and think what is this all about.
Man: Yes, definitely the title hospital charges.
Man: Safety catches my eye because that is what I asked a lot of questions about when I have looked at reports.
I know that you have not had enough time to digest this; you have not had time to read anything but, tell me what is your impression, what are your overall thoughts about this booklet?
Man: At a quick glance it seems to be a ton of information.
Man: I liked the fact that it showed the cost of vaginal vs. cesarean vs. with complications and with out complications.
Man: Sure, I would like to have every possible situation detailed so that you can know.
Man: Looks like there was a lot of people studied, 42,000 cases so it looks like it is true from all of the different people you have studied under.
Man: Legitimate, yes.
Woman: How are you supposed to know what hospital V is and County 9?
Woman: So when it comes out it will say which hospital it is so that you wouldn’t like have to flip from one page to another to see what it is?
Facilitator: It will say what hospital it is.
Man: Something that I am thinking, I don’t know if anyone else even agrees with me, but out of all of the stuff that I have read during the pregnancy and everything. I mean it has all of the information that I would want to know about these things. But everything that I have read I really liked it when I feel like I have a connection with the writer and that there is a bit of dialog not just stats and facts. Like just umm, I guess there is no real way to put a personal experience from the state health what ever but umm.
Man: Yes.
Man: Yes.
Woman: Is it a preface?
Woman: Kind of tell about who gave the data.
Woman: Yea.
Man: Yes.
Woman: Yes
Man: Very clear.
Facilitator: Meaningful?
Man: Yes
Woman: Yes
Man: With the definitions of complications
Facilitator: We have some nodding their heads.
Man: Yes
Man: Yes
Man: Yes
Woman: So it says if there are fewer than five cases they are a zero thingy, what does that mean.
Facilitator: It means that the hospital did not have enough cases to really count, and if it was less than five they were not included. Would you turn to page 13 now and we are going to do the same thing. Tell me what that chart tells you.
Man: The rate of vaginal deliveries among women who have had a previous c-section delivery.
Man: And how that corresponds to the staff that they keep on hand. So, I mean if I sat down and actually paid attention to the numbers, I would be able to tell if the ones that have an Obstetrician on staff and an Anesthesiologist on staff have a higher success rate or lower success rate depending on what the numbers would say. That is another thing is that a summary might be good of what it says like as you can see blah, blah, blah.
Facilitator: So your summary of this page would be, that there must be a
reason you are telling me that there is an Obstetrician and an Anesthesiologist
on staff and it must be better to have both of those things.
Man: If that is what the stats say.
Man: Right.
Facilitator: Anything else?
If you found this in your doctors office or in the library would you pick one up and take it home?
Woman: Yes…yes…yes
Facilitator: What if it was about heart disease?
Man: In an Obstetricians office?
Facilitator: Let’s pretend for just a moment. So the reason you would pick it up would be that?
Woman: it pertains to us.
Facilitator: That it pertains to you very specifically. How many of you have a choice about which hospital you go to? You have probably already decided, but did you have a choice early on?
Man: Yes
Man: Yes
Woman: Yes
Man: Yes
Facilitator: So all of you had a choice, Good. And how did you make your decision?
Woman: Doctor encouraged us to go.
Man: Other people’s experiences, word of mouth.
Woman: Information about the delivery rooms from what other people had said.
Facilitator: So word of mouth was an important piece?
I would like you to turn to one more page and that is page 20. And I want you to just look through that briefly and tell me how useful that information is to you.
Man: I didn’t notice but did they put these phrases/words in bold earlier in the thing to let you know that there is a definition?
Man: I would think that this page should be earlier anyways, so that you cross it before you start reading the packet.
Woman: It’s supposed to be in the back.
Facilitator: So, it would be helpful if that was earlier on so that you would know that there were some definitions there and that you could look some things up.
Man: It would catch my eye. Oh yea…if I have some questions I can go back to this page and use this.
Man: The table of contents says additional resources but it doesn’t say that it is a glossary or what it is.
Woman: Yes, it is helpful.
Man: Yes, it is good to have this stuff.
Woman: Make a better choice on the hospital that we are at.
Man: Well you know sometimes I feel that one person can’t really do anything, but if I am looking at my hospital and it has had this many lacerations giving birth maybe they should pay attention to that. Or if they have had this many people get in that should not have gotten in, that they need to increase their security and I can go to the Director of the hospital and say what is going on.
Woman: It could make you more aware of some of the problems that they usually have.
Facilitator: It might lead you to ask some questions?
Man: Yea, should I sue them because they do something stupid?
Facilitator: With your brief look through this booklet, does it raise any questions that you might want to see answered in a booklet like this?
Man: The only thing I was questioning was what kind of complications caused this rise to increase?
Facilitator: So it’s not clear to you why?
Man: What’s complicated.
Man: What extra services do they have to deliver, why it made it go up so much?
Man: I think like a big thing is like to know how much an epidural is compared to a natural birth, things like that different prices of anesthesia.
Facilitator: So you would like to see some detail, some costing out of individual items instead of total price?
Man: Yea, because I am a tight wad and I don’t want to pay for an epidural.
Man: Well I think it depends on what your insurance is going to cover, if they are going to cover the percentage I don’t care what they do. Do what they need to do, I am not going to pick and choose whether she has an epidural or not. You know that it is her decision.
Man: Yea.
Man: I think a lot depends on whether you can get your insurance company to pay for it or not. I want to know how much is going to come out of my pocket.
Man: I know that I pay 10 %, I just want to know how much I should save up, prepare myself for. That you know six hundred dollars or what ever.
Man: Oh yea.
Woman: Now you know where they all are. And you could actually check them out if you wanted to.
Man: This will help out with where they are located and that they are actually comparable to other hospitals.
Woman: It’s nice to know how many beds they have.
Man: That’s not just maternity beds right? That might be labor and delivery and how many other beds they have?
Facilitator: Yes.
What do you think you learned by knowing how many beds? How would that be able to help you?
Man: I don’t want to be surrounded by five screaming women; I would rather be surrounded just by my wife, so.
Woman: You learn how big are the hospitals, the bigger hospital the better that’s how I think about it.
Man: If you had the number of staff as well, because if they have 520 beds and not as many staff they have to spread that staff out to so many more people.
Facilitator: So a staffing ratio might be a helpful piece of information?
Woman: Maybe if they are private beds.
Woman: I think you could give more information on the hospital itself
Man: I didn’t realize that the charges were so different in each hospital.
I figured that it was just a flat rate, but obviously it is not. Do these
charges change in these hospitals yearly?
Facilitator: Well these are average charges, so each patients may have had a slightly different charge based on what did they get. Did you get the epidural or did you not, etc. So those are averages and they probably do change from year to year, partly patient mix and partly cost increases.
Woman: There are a lot of other charges that we get charged for, like if you needed a razor or something all that kinds of stuff or no. That would be kind of nice to know because back in the day I remember when my sister had a baby she got a whole list of charges for like an aspirin, a razor, a brush just like little things that she didn’t have that she would have liked to know what she would have been charged eighty bucks for an aspirin.
Facilitator: Just like the mini bar in the hotel, you wonder how much it is going to cost you if you eat those M&M’s. To know up front if your willing to pay that.
Mike do you have any other questions that you would like to pose this group?
Mike: No I don’t. This was perfect.
Facilitator: You have been very, very helpful. I do have to ask for you to give the guide back to me because at this point they are not ready for publication.
Woman: Do you know how long it will be until they are available?
Facilitator: We expect to have these within the next 6 weeks.
There was a dialogue about the cover as they were leaving the room. Someone said that the top title should be smaller and the part that tells what is really inside should be more prominent. It was suggested that some kind of highlight of what was inside on the front cover would be helpful.