Search

A sample of 3,201 Danes was subjected to personal interviews in which they were asked to state their preferences for risk-reducing health care interventions based on information on absolute risk reduction (ARR) and relative risk reduction (RRR). The aim of the study was to measure the relative weighting of different types of risk information under various circumstances. The effect of presenting questions, and of explicitly formulating RRR, was analyzed. A preference for increases in RRR was demonstrated. There was a stronger inclination to choose the intervention that offered the highest RRR if RRR was explicitly stated. Individuals with more than 10 years of schooling also demonstrated a preference for increased ARR, but only when facing individually framed choices. In a social choice context, preferences for RRR remained intact, but the magnitude of ARR had no impact on choices. Results imply that social framing may induce a propensity to prefer interventions that target high-risk populations. Those respondents who had received ≤10 years of schooling demonstrated preferences for RRR but not ARR, and no impact of social framing was observed. [ABSTRACT FROM AUTHOR]

Presents comments on the reply by Reventlow et al. for their article related to concept of risk communication in relation to a patient with osteoporosis as published in December 2002 issue of 'Scandinavian Journal of Primary Health Care.' Disagreement over conclusions drawn by Reventlow et al. from their observations; Assertion over personal valuation of risk deductions; Importance of risk in medical practice.

Objective: Private health insurance is becoming more common in Norway. The aim of this study was to investigate GPs' opinions on private health insurance, and their experiences from consultations where health insurance can affect decisions about referring., Design: A web based cross-sectional survey., Setting: Norwegian general practice., Subjects: All GPs in Norway were in 2019 invited to participate in an online survey., Main Outcome Measures: The GPs' opinions and experiences regarding health insurance were reported as proportions. Multiple logistic regression was used to test associations between how frequently GPs refer patients without further considerations and variables concerning their characteristics, opinions, and experiences., Results: Of 1,309 GPs (response rate 27%), 93% stated that private health insurance raises the risk of overtreatment and 90% considered such insurance to contribute to inequality in health. Frequently being pressured to refer in the absence of a medical indication was reported by 42%. Moreover, 28% often or always chose to refer patients without further consideration, and this was associated with perceptions of pressure with an adjusted odds ratio (AOR) of 3.80, 95% confidence interval (CI) 2.73-5.29, and unpleasant reactions from patients following refusals (AOR 1.63, 95% CI 1.14-2.33)., Conclusion: Although most participating GPs associated private health insurance with overtreatment and inequality in health, more than one in four choose to refer without further consideration. GPs' experience of pressure to refer and negative reactions from patients when they consider referrals not to be medically indicated, raises the risk of medical overuse for patients holding private health insurance.

Introduction: The purpose of this study was to examine whether there are differences in the use of general practice between citizens in low income groups and citizens with higher income after adjustment for social and health-related factors., Material and Methods: Registers from Statistics Denmark on adult citizens of Odense Municipality in 2005 were used. Income was measured as annual equivalent disposable income and adjustment for social and health-related personal characteristics was performed using Poisson regression., Results: Poor adults with income below 73,000 DKK have 2-3 fewer contacts with general practice annually than those with an income of 73,000-146,000 DKK, while adults with an income above 292,000 DKK have the lowest utilization of general practice of any group. The difference between the poor and those with low income was reduced to 1.5 fewer contacts after adjustment for social and health-related characteristics and further to 1,1 when a sizeable unidentified socio-economic group was omitted., Conclusion: Poor adults have significantly fewer contacts with general practice than adults with low or middle income. This contrasts with results from earlier studies and may be an indication of underutilization of general practice. Other explanations may be that poor citizens enter the primary health sector through other channels or that the type and quality of contacts vary between income groups, that adjustment for health or other need indicators are insufficient. Furthermore, data shortcomings such as lack of information on non-taxed income and non-taxable assets may also serve as alternative explanations.

Introduction: Statistics and a good understanding of numbers are important professional tools for doctors in order to understand and communicate risk estimates., Materials and Methods: In this questionnaire survey carried out among 129 specialist trainees the ability to calculate and compare risk values (Relative Risk Reduction, Absolute Risk Reduction, Number Needed to Treat and a combination of these) was examined along with the general understanding of numbers in relation to probabilities., Results: The survey showed that 69% of the participants were able to calculate a risk reduction accurately. Answers from the respondents did not depend on whether information was given as absolute or relative risk reductions. 13% of the participants were able to correctly estimate the risk of a false positive answer in connection with screening., Conclusion: The trainee doctors demonstrated a surprisingly poor ability to make basic probability calculations and a poor understanding of screening results. A thorough understanding of risk measures as well as basic probabilities is a prerequisite for good objective patient information. This survey indicates that there is considerable room for improvement in these areas.

A sample of 3,201 Danes was subjected to personal interviews in which they were asked to state their preferences for risk-reducing health care interventions based on information on absolute risk reduction (ARR) and relative risk reduction (RRR). The aim of the study was to measure the relative weighting of different types of risk information under various circumstances. The effect of presenting questions, and of explicitly formulating RRR, was analyzed. A preference for increases in RRR was demonstrated. There was a stronger inclination to choose the intervention that offered the highest RRR if RRR was explicitly stated. Individuals with more than 10 years of schooling also demonstrated a preference for increased ARR, but only when facing individually framed choices. In a social choice context, preferences for RRR remained intact, but the magnitude of ARR had no impact on choices. Results imply that social framing may induce a propensity to prefer interventions that target high-risk populations. Those respondents who had received < or = 10 years of schooling demonstrated preferences for RRR but not ARR, and no impact of social framing was observed.

Introduction: Uncertainty and risk are central issues in relation to health and health care services. Healthy individuals do not necessarily fall ill, despite the presence of risk factors. Doctors, health service administrators, and patients are more inclined to choose interventions against risk factors, when information about the effects is presented in terms of relative risk reductions rather than absolute risk reductions. The aim of the study was to gain better insight into how general practitioners (GPs) perceive risk of disease, and whether this perception depends on the risk reduction being presented in absolute or relative terms., Material and Methods: Questionnaires with clinical episodes were sent to 1500 Danish GPs. The GPs were randomised into four groups of 375, all of whom received the same case history with information about risk reduction achieved through medical treatment phrased in terms of either relative risk reduction, absolute risk reduction, number needed to treat, or all of the aforementioned terms of risk reduction. The GPs were asked whether they would recommend medical treatment as primary prevention, knowing the case history and expected risk reduction., Results: The GPs' attitude towards recommending medical treatment depended on the phrasing of risk reductions. Of the doctors who received all information on risk reductions, 72% would definitely or probably recommend medication, whereas 91% would recommend medication if only information about relative risk reduction was given, and 63% would recommend medication if information was given in terms of absolute risk reduction or number needed to treat., Discussion: To advise patients rationally, knowledge of the patients' preferences, as well as consideration of all available measures of risk reductions, is needed.