How sophisticated are consumers about the medical care delivery system?

A 10-item questionnaire was administered to non-elderly persons (N = 4,976) to measure their sophistication or knowledgeability about the medical care delivery system. Such sophistication seems germane to views about the appropriate role consumers might play in decisions affecting resource allocation, especially whether competition or cost-sharing strategies should be pursued or whether certain regulatory strategies are more promising. Analyses of individual items suggest that consumers are knowledgeable about some matters and uninformed about others. If a pro-competitive strategy is pursued, efforts at educating consumers about board certification, staff privileges and other information pertinent to choosing a regular source of care seems warranted. Factor analyses indicated that a substantial amount of the information contained in item responses can be summarized in a multi-item scale score. The reliability and validity of this scale as a measure of patient sophistication was supported.