Abstract
Background: The Osteopathic Survey of Health Care in America (OSTEOSURV) is a decennial national telephone survey. Its goals are to monitor longitudinal trends in awareness, beliefs, utilization, and patient satisfaction relating to osteopathic physicians and to assess beliefs and attitudes regarding contemporary health care issues in the United States. The questionnaire was validated during the administrations of OSTEOSURV-I and OSTEOSURV-II in 1998 and 2000, respectively. In OSTEOSURV 2010, the contemporary health care issues of interest are patient-centered care and the Patient Protection and Affordable Care Act of 2010.
Methods: The target population was household residents of the United States aged 18 years or older. A total of 10,308 random landline telephone numbers were dialed using a computer-assisted telephone interviewing system to acquire 1000 completed interviews between July 23, 2010, and October 1, 2010. The response, cooperation, and contact rates as defined by the American Association for Public Opinion Research were comparable to those of other national telephone surveys. The survey provides an estimated margin of error no greater than 3% to 4% for both general items and for those relating to the subset of respondents claiming to be aware of osteopathic physicians. Because respondents were older and more likely to be female than referents in the general population, the observed responses will be weighted by age and sex to reflect the US Census estimates for persons aged 18 years or older in 2010.
Discussion: OSTEOSURV 2010 was successfully fielded as the latest national telephone survey relevant to osteopathic medicine and contemporary US health care issues. Data analysis should yield important new findings relating to osteopathic physicians, patient-centered care, and the Patient Protection and Affordable Care Act that may not be readily observed through other national health care data sets. While underrepresented in this survey, which excluded cell phone–only participants, young adult respondents were reflective of their national age referents with regard to health insurance coverage and general health status. Thus, it appears likely that statistical weighting by age and sex of the OSTEOSURV 2010 data will minimize potential bias in estimates of health-related items. Rapidly evolving technology and sociocultural transitions will necessitate changes in the design of OSTEOSURV 2020.
The Osteopathic Survey of Health Care in America (OSTEOSURV) is a decennial national telephone survey. Its main goals are to monitor longitudinal trends in awareness, beliefs, utilization, and satisfaction relating to osteopathic physicians and to assess beliefs and attitudes regarding contemporary health care issues in the general population of the United States. The previous administrations of OSTEOSURV-I in 1998
1 and OSTEOSURV-II in 2000
2 validated the OSTEOSURV questionnaire, including the core anchor items relating to osteopathic physicians and other survey domains.
3
The Osteopathic Survey of Health Care in America complements the large national surveys that provide data sets for secondary analysis in the realm of health services and policy research. Two important advantages of these national surveys are that they are generally representative of the US population and that they are statistically powerful. For example, the National Ambulatory Medical Care Survey has been used to study the practice patterns of osteopathic physicians in delivering family and general medical care as well as preventive medicine services,
4 managing low back pain,
5 and providing medical care at academic health centers.
6 However, there are often 2 major limitations of such national data sets. Most obviously, the research hypotheses are limited to those soluble with the data provided within the survey questionnaires or interviews. Secondly, because the data are frequently collected through physician offices, hospitals, or third-party administrators, the patient perspectives of health care delivery are frequently lacking. The Osteopathic Survey of Health Care in America fills these voids by addressing osteopathic medicine and related contemporary health care issues and by asking patients about their beliefs, utilization, and satisfaction relating to health care.
The contemporary health care issues of interest in OSTEOSURV 2010 are beliefs about patient-centered care and the Patient Protection and Affordable Care Act of 2010 (PPACA). Patient-centered care was highlighted by the Institute of Medicine in 2001,
7 wherein it recommended that health care should be patient centered, in addition to being safe, effective, timely, efficient, and equitable. Six commonly accepted dimensions of patient-centered care are the following: respect for patients' values, preferences, and expressed needs; coordination and integration of care; information, communication, and education; physical comfort; emotional support (eg, relieving fear and anxiety); and involvement of family and friends.
7,8
The PPACA has been described as the most consequential social legislation of our generation, arguably transforming all aspects of health care in the United States by mandating minimum health insurance coverage, providing federal subsidies to qualified individuals to help offset the cost of such mandated coverage, imposing extensive new requirements on the health insurance industry, and placing additional regulations on the practice of medicine.
9 Since its enactment on March 23, 2010, there has been much debate about the positive and negative implications of health care reform, including PPACA implementation and its potentially transformative effect on the US health care system.
The Osteopathic Survey of Health Care in America 2010 is supported by a grant from the Osteopathic Heritage Foundation (Columbus, Ohio). The sponsor provides financial support only and has no role in the design and conduct of the survey; the collection, management, analysis, and interpretation of the data; or the preparation, review, or approval of manuscripts for publication.