The effects of social support and confidence in the health care system on the likelihood of hiring a health advocate

BACKGROUND: In response to the increasing complexity of the health care system, the field of health advocacy has emerged. However, little is known about factors that may influence a person’s likelihood of hiring a health advocate. PURPOSE: This study was designed to examine factors that influence a person’s likelihood of hiring a health advocate. METHODS: The participants were 889 randomly selected community members who were assigned to read one of six vignettes. Social support and confidence in the health care system were manipulated in the vignettes. Social support was either high or low and overall confidence was high, moderate, or low. The dependent variables were participants’ likelihood of hiring a health advocate and the hourly rate participants were willing to pay for a health advocate for six different services. RESULTS: The results indicated that social support did not affect the likelihood of hiring a health advocate; however, confidence in the health care system did affect the likelihood of hiring a health advocate. Participants who read vignettes, in which the patient was described as having lower overall confidence levels, indicated a greater likelihood of hiring a health advocate than participants who read the vignettes in which the patient was described as having high confidence. CONCLUSIONS: More research is needed to determine other factors that may influence the likelihood of hiring a health advocate and whether hiring a health advocate is a cost-effective way to improve the quality of health care by reducing the number of medical mistakes and improving patient-provider communication.