title: When parents are given greater access to health information, does it affect pediatric utilization?
abstract: OBJECTIVE
  Most studies assessing the effects of consumer health information on medical utilization have used randomized controlled clinical trials with the chronically ill. In this paper, we analyze the effect of the Healthwise Communities Project, a natural experiment that provided free self-care resources, on reported pediatric utilization.
  
  
  METHODS
  Random household surveys were collected before and after the intervention in Boise, Idaho and in two control communities.
  
  
  METHODS
  A total of 5,909 surveys were completed, representing an overall response rate of 54%. Of these, 1,812 respondents were between 18 and 55 years of age and had children under 18 years of age living in the home. All analyses were restricted to these 1,812 persons.
  
  
  METHODS
  Parents were asked how many times their children visited a physician in the last year. Responses were gathered with a categorical response scale, which was then transformed into a continuous variable (number of pediatric visits).
  
  
  RESULTS
  The intervention was associated with a decrease in reported pediatric utilization rates. The decrease in visits ranged from -0.72 to -0.66 (P approximately 0.05), depending on the statistical model used. Further analyses of 423 families followed over time found a more modest decrease (-0.19) that was not statistically significant.
  
  
  CONCLUSIONS
  This study found that increasing access to self-care books, telephone advice nurses, and Internet-based health information is associated with decreases in reported pediatric utilization. However, the significance of the results was sensitive to the statistical model. More research is needed to understand the average and marginal costs of providing health information to consumers.
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: M R
authors.initials: MR
authors.lastname: Greenlick
mesh_terms: D000328:Adult; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education; D006300:Health Services Misuse; D006801:Humans; D007061:Idaho; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009819:Office Visits / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012648:Self Care; D012680:Sensitivity and Specificity; D014600:Utilization Review / Q000379:methods*