A health economist talks with WTOP about recent research on making better health care decisions

Andrea K. Kantor, an associate professor of health administration at the University of Pennsylvania’s Wharton School, was recently honored by Health Affairs for her contributions to the discussion about transforming the delivery of care. The principal research investigator of “Spreading the Costs and Cost Benefits” an article published last month in the Public Health Service Journal, Kantor spoke with WTOP about recent work published in Health Affairs that suggests helping patients make health care decisions will be key to improve health outcomes.

Q: Why did you focus on patients as the key?

A: I knew that in health care, many patients are quite dysfunctional. There is a perception in health care that patients are more accountable for their health, but a recent survey we conducted around patients and their concerns about health and their views on health care tells a completely different story. People are very frustrated, and many of them are not getting what they are supposed to get from their health care providers.

Q: There is a perception that health care is inherently complicated, but patients often don’t have enough information to make informed decisions. Why is that?

A: Patients are overwhelmed, and the complexity is exacerbated by the fact that we do not have a very strong framework or value-based provision, or healthcare policy that is transparent to consumers.

Q: When patients make health care decisions, they often want to know whether treatment will help their health in the long term. Would these insights be an easy way to save money, or even improve health outcomes?

A: One of the things we see from our survey is that patients want to know about outcomes. The evidence suggests that outcomes matter, particularly with better quality and outcomes in terms of using less resources and helping people get better faster.

Q: What would it take to establish an evidence-based framework for this?

A: It’s very challenging to do this because no one has done that before. The health systems know that outcomes matter, so why don’t we have some type of mechanism by which patients can pick things like better outcomes, and that they are not told, “Oh, the treatment is not going to improve.”

Q: What is your advice to health-care policymakers and managers who are trying to meet their customer’s needs?

A: I would like to stress that the whole game in health care changes when you start to understand that people who care for you are not for profit. They care for you because they know the answers to your questions, and they provide that level of care because they want to get you better. So it’s really important to put health care in a patient-centered context. All kinds of organizations (like universities and hospitals) are moving this way, so why not health care? … Everyone here is in the room with you to solve problems, not to just get paid, (and) make money.

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