title: Does providing consumer health information affect self-reported medical utilization? Evidence from the Healthwise Communities Project.
abstract: OBJECTIVE
  To determine whether providing health information to residents of Boise ID had an effect on their self-reported medical utilization.
  
  
  METHODS
  The Healthwise Communities Project (HCP) evaluation followed a quasi-experimental design.
  
  
  METHODS
  Random households in metropolitan zip codes were mailed questionnaires before and after the HCP. A total of 5,909 surveys were returned.
  
  
  METHODS
  The dependent variable was self-reported number of visits to the doctor in the past year. A difference-in-differences estimator was used to assess the intervention's community-level effect. We also assessed the intervention's effect on the variance of self-report utilization.
  
  
  RESULTS
  Boise residents had a higher adjusted odds of entering care (OR = 1.27, 95% CI 0.88, 1.85) and 0.1 more doctor visits compared with residents in the control cities; however, for both outcomes, the effects were small and not significant. Although the means changed little, the data suggest that the variance of utilization in Boise decreased.
  
  
  CONCLUSIONS
  The HCP had a small effect on overall self-reported utilization. Although the findings were not statistically significant, a posthoc power analysis revealed that the study was underpowered to detect effects of this magnitude. It may be possible to achieve larger effects by enrolling motivated people into a clinical trial. However, these data suggest that population-based efforts to provide health information have a small effect on self-reported utilization.
authors.affiliation: VA HSR&D Health Economics Resource Center, Center for Primary Care and Outcomes Research, and Center for Health Policy, Stanford University, CA, USA. twagner@stanford.edu
authors.forename: T H
authors.initials: TH
authors.lastname: Wagner
authors.forename: J H
authors.initials: JH
authors.lastname: Hibbard
authors.forename: M R
authors.initials: MR
authors.lastname: Greenlick
authors.forename: L
authors.initials: L
authors.lastname: Kunkel
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D006300:Health Services Misuse; D006801:Humans; D007061:Idaho; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009819:Office Visits / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D010548:Personal Health Services / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012648:Self Care; D012647:Self-Assessment; D014600:Utilization Review / Q000379:methods*