Does providing consumer health information affect self-reported medical utilization? Evidence from the Healthwise Communities Project

Med Care. 2001 Aug;39(8):836-47. doi: 10.1097/00005650-200108000-00009.


Objective: To determine whether providing health information to residents of Boise ID had an effect on their self-reported medical utilization.

Research design: The Healthwise Communities Project (HCP) evaluation followed a quasi-experimental design.

Subjects: Random households in metropolitan zip codes were mailed questionnaires before and after the HCP. A total of 5,909 surveys were returned.

Measures: 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.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Female
  • Health Services Misuse*
  • Humans
  • Idaho
  • Male
  • Middle Aged
  • Models, Theoretical
  • Office Visits / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Education as Topic*
  • Personal Health Services / statistics & numerical data*
  • Regression Analysis
  • Self Care*
  • Self-Assessment*
  • Utilization Review / methods*