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New Yorkers Worried About Health Care Costs, Less on Quality
New York Ag Connection - 09/13/2017

High cost is by far the most important health care issue for New Yorkers, and their concern about it is growing.

In a recent survey of a representative sample of New York state residents, 58 percent said the high cost of health care is their biggest concern. That's a rise of 12.6 percentage points from last year, according to a new study from the Cornell Institute for Healthy Futures (CIHF).

Worries about the high costs of medication and insurance also rose by several percentage points in 2017, compared with 2016. Concerns about lack of access to care rose to 23.5 percent, from nearly 15 percent last year.

"We think that this change is because the health care law, also known as Obamacare, may be reversed or replaced," said doctoral candidate Lu Kong '13, a co-author of the study. "Without it, premiums, copays and all the out-of-pocket expenses are expected to go up. That's why high cost was a big concern last year and even more of a concern this year."

Survey respondents were far less worried about their quality of clinical care, said co-author Rohit Verma, dean of external relations, executive director of CIHF and the Singapore Tourism Board Distinguished Professor in the Cornell SC Johnson College of Business.

"That result tells me that the technical competence of our medical care in New York is really good," Verma said. "But the infrastructure, the supporting business model we have created around health care, is a bigger problem than the clinical care. That, to me, was a surprise, but it was a pleasant surprise."

The research team also found that most people -- nearly 65 percent -- had a positive reaction to their doctor using a computer, tablet or other electronic devices during a face-to-face interaction. "Those people said it was more efficient way of organizing medical records, and the doctor had faster access to more information with which to make better decisions about their health care," said study co-author Hessam Sadatsafavi, a postdoctoral associate at CIHF.

And a clear majority -- more than three-quarters -- of the survey respondents said they'd be willing to use telemedicine to get health care from a distance, via telecommunication and information technology. But that's just for minor health problems; only 18 percent said they'd be willing to use telemedicine for a major problem.

Generally, people in the survey seemed willing to use technology in their health care, Verma said. "That result informs me that if we do technology implementation right, then it could in the long run positively affect cost problems and hopefully access problems that patients currently face."

That said, the team did find disparities in willingness to use technology. Younger people and those with higher education and income levels were more comfortable with technology compared with older people and those with lower education and income.

But race, ethnicity and geographical location didn't matter.

"It seems that income, education and age are the most important factors in determining whether people use these services," the co-authors said. "Care providers and decision-makers should understand this disparity."

Plenty of research and news articles have explored ways to improve health care operations, such as strategies to increase efficiency and reduce wait times, Kong said.

"But patients might not think those are the most important issues to address," she said. "That's why we asked these questions; we wanted the consumers' point of view."

The team crunched data from the 2017 Empire State Poll, conducted via phone by Cornell's Survey Research Institute between February and April 2017. The poll annually surveys a randomly selected, representative sample of 800 New York state residents on a range of community, economic and social science issues. Each year the survey also includes questions proposed by Cornell faculty members about topical issues. For the past two years, CIHF researchers have included questions about New Yorkers' opinions about health care.

The Cornell Institute for Healthy Futures is the first academic center in the country to provide a multidisciplinary platform for integrating hospitality, health management and policy, and design to enhance service excellence in health care, wellness, senior living and related industries.

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