A global Healthcare survey presented to the Market Research Society Healthcare Conference, London 2012

1. Global Health Survey
EXPERIENCE & PERCEPTION IN 28 COUNTRIES
International Research Institutes www.irisnetwork.org
1

2. 2

3. International Research InstituteS
3
INRA
(1950’s)
IRIS
(1986)
Split in the
1980s
5-6 members (Demoscopie (Fra),
RSL (UK), NSS (NL),
Demoscope (SUI), Data (Esp)
B&A joined 1997
FDS (now SPA Future Thinking)
2005
33 members in 2012

4. International Research Institutes
• A voluntary trade association (non-ownership)
• Representing and consisting of quality, multi-disciplinary
Independent Agencies.
• Thought leadership, sharing experiences, working
groups.
• A network with trusted, local expertise overseas.
• Meet personally every six months and virtually much
more often.
4

5. Our Stud5 y

6. IRIS International Health Survey
• First fielded in 2004….21 countries, slightly smaller-scale.
• Fielded again Autumn 2011:
– 28 countries
– 22,000 interviews
– Mix of methodologies
– Romania/Canada/Ireland-lead but planned by a group
of fifteen.
6

7. Sample Sizes X Country
BASE Method Total
TOTAL 21988
Finland Online 500
France CATI 959
Germany Online 1087
Greece CATI & Online 1002
Hungary CATI 500
Ireland Face-to-Face 1000
Italy Telepanel 2030
Lithuania Face-to-Face 1005
Netherlands Online 1062
Poland Online 812
Romania Face-to-Face 1100
Russia CATI 520
Slovenia Online 501
Turkey CATI 417
UK Online 1000
Ukraine Face-to-Face 600
BASE Method Total
TOTAL 21988
USA Online 1014
Canada Online 1006
Chile Online 640
Colombia Online 506
China
Online & Face-to-
Face
1000
India Face-to-Face 1056
Indonesia Face-to-Face 500
Online & Face-to-
Malaysia
Face
427
Thailand Online 540
Pakistan Face-to-Face 300
Egypt CATI 500
Australia Online 910

8. Sample Sizes X Region
BASE Method All respondents
TOTAL 22364
India Face-to-Face 1056
China
Online &
Face-to-Face
1000
Asia + Africa
CATI, Online &
Face-to-Face
2270
Australia Online 910
East / Central Europe
CATI, Online &
Face-to-Face
4956
Western Europe
CATI, Online &
Face-to-Face
9007
Americas Online 3166

9. Scope
• Perceived Health
• Contributors to Health
• Assessment of Local Systems
• Funding Preference
• Interaction with HCPs
• Opinion of Family Physician
• How we gather information or health
• Personal input desired on health treatment
• Pervasiveness of suicide and related mental conditions
9

10. 10
System Failings

11. System Attitudes
• Broad view persists of crisis in healthcare systems.
• The general view is that management failings are the
primary detractor moreso than underfunding.
• The European perspective is predominantly negative,
even in ‘good’ systems: government or national handing
invariably criticised.
• Healthcare as a sector clearly needs “better press”.
11

12. National Health System: Good Shape or Crisis
Excellent Very good shape
33
69
56
42
42
39
34
3
12
3
1
6
0
4
2
1
2
2
0
1
1
26
24
24
23
19
17
12
12
9
6
0
All Countries
Turkey
Finland
UK
Netherlands
Lithuania
France
Italy
Slovenia
Germany
Ireland
Hungary
Russia
Greece
Poland
Ukraine
Romania
51
24
18
8
81
66
66
62
51
23
7
48
3
0
1
0
20
8
14
6
4
3
5
Canada
Chile
USA
Colombia
Indonesia
Malaysia
India
Thailand
China
Pakistan
Egypt
Australia

13. Regional Healthcare System Evaluation
66
51
50
48
Excellent Very good shape
22
30
28
14
4
8
5
1
2
1
India
China
Asia + Africa
Australia
East / Central Europe
Western Europe
Americas

14. Approval of National Healthcare System
Strongly approve Somewhat approve
34
77
41
41
37
35
32
32
32
6
24
23
20
19
17
16
11
5
47
2
4
3
4
4
5
5
1
1
1
5
2
2
1
1
All Countries
Turkey
Finland
Netherlands
UK
Hungary
Russia
France
Ireland
Slovenia
Lithuania
Italy
Greece
Germany
Poland
Ukraine
Romania
Management
42
30
29
19
83
78
72
54
53
25
17
39
2
2
4
1
31
27
20
3
6
0
4
6
Canada
Chile
USA
Colombia
Indonesia
India
Malaysia
China
Thailand
Pakistan
Egypt
Australia

15. Source of Problems in the Healthcare System
Inefficient management Not enough funding
63
87
84
79
74
67
64
61
59
58
58
57
50
50
47
37
37
30
10
10
19
24
27
28
38
34
42
42
37
24
41
35
47
52
All Countries
Slovenia
Germany
Greece
Poland
Russia
Ireland
Lithuania
France
Netherlands
Romania
UK
Turkey
Ukraine
Italy
Finland
Hungary
95
72
72
62
79
68
66
64
62
43
69
42
5
27
10
30
16
32
34
27
35
42
29
46
Colombia
Chile
USA
Canada
China
Indonesia
Thailand
India
Pakistan
Malaysia
Egypt
Australia

16. Funding Preference: Health Expenses of
Governments, through taxation Private individuals
67
84
83
83
82
82
81
78
75
74
73
69
68
65
53
53
46
25
12
17
14
18
9
16
12
14
21
21
9
26
18
38
41
44
All Countries
Turkey
Netherlands
Lithuania
Romania
UK
Greece
Finland
Hungary
Poland
Slovenia
Italy
Russia
Ireland
France
Ukraine
Germany
Individuals
77
76
75
35
72
67
60
52
51
42
68
65
13
16
19
46
21
33
35
48
46
58
29
23
Canada
Columbia
Chile
USA
Malaysia
Indonesia
Pakistan
Thailand
India
China
Egypt
Australia

17. 17
Health
Contributors

18. Global Behavioural & Attitudinal Differences
• Interesting differences across continents in relation to
tobacco, alcohol, diet and other perceived contributors.
• European and American obsessiveness or
fastidiousness.
• Asian ignorance in relation to some key contributors.
• Key implications for public health initiatives.
18

19. Factors Contributing to Health
92
89
88
88
88
87
86
84
84
78
Very important Somewhat important
77
52
56
49
51
44
54
47
43
43
54
44
Level of physical exercise
Contaminants that affect one’s water and food supply
Insufficient or poor quality sleep
The diet one chooses on a regular basis
Family’s health history or genetics
Stress and anxiety
Air pollution
Use of prescribed medications
Outlook on life
Use of tobacco
The amount of alcohol consumed on a regular basis

20. Very Important Contributors to Health by
Region
TOTAL 22490 1056 1000 2266 910 4956 9137 3165
Contaminants that affect one’s water
56% 40% 54% 63% 41% 61% 55% 58%
and food supply
Stress and anxiety 54% 16% 46% 37% 52% 59% 56% 69%
Use of tobacco 54% 9% 40% 31% 60% 54% 60% 71%
Level of physical exercise 52% 54% 39% 62% 46% 52% 47% 61%
The diet one chooses on a regular
51% 67% 53% 56% 56% 47% 47% 60%
basis
Insufficient or poor quality sleep 49% 36% 52% 51% 47% 52% 46% 56%
Air pollution 47% 40% 40% 58% 27% 53% 44% 48%
Family’s health history or genetics 44% 38% 44% 42% 38% 46% 42% 51%
The amount of alcohol consumed on a
44% 9% 28% 26% 47% 47% 49% 53%
regular basis
Use of prescribed medications 43% 60% 22% 54% 34% 42% 40% 48%
Outlook on life 43% 43% 30% 44% 42% 42% 39% 57%

21. Tobacco as a Health Contributor x Region
94
86
86
80
76
47
Very important Somewhat important
17
71
60
40
54
60
31
9
Americas
Western Europe
China
East / Central Europe
Australia
Asia + Africa
India

22. Alcohol Consumption as a Health
Contributor
93
85
81
80
79
44
Very important Somewhat important
16
53
49
28
47
47
26
9
Americas
Western Europe
China
Australia
East / Central Europe
Asia + Africa
India

23. 23
Good Doctor/Bad System?

24. A Health Paradox
• A relatively poor perspective of the health system is
accepted.
• In contrast, the family physician is very positively
perceived.
• Suggests a common hardware/software conundrum, or
perhaps an explicable manager/carer issue.
• Is the public simplistic in its analysis? Should the system
be more obviously managed by HCPs rather than
bureaucrats.
24

25. Usage of Key HCPs for Health Related Services in
59
45
43
24
19
13
7
7
4
65
36
18
13
15
10
3
2
2
68
38
33
9
39
16
6
5
5
Family GP in public system
Pharmacists
Specialists in the public system
Physicians in the private health system
Nurse
Physiotherapists
Dietician/Nutritionist
Psychologist
Social worker
Global
Ireland
UK
Past Year

26. Satisfaction with the Family Physician
Very satisfied Satisfied at all
84
95
95
94
92
89
88
88
87
83
81
78
77
76
75
65
57
34
56
45
65
47
46
56
9
41
26
22
32
20
10
20
9
13
All Countries
Netherlands
France
Ireland
Hungary
UK
Turkey
Lithuania
Romania
Germany
Slovenia
Greece
Italy
Poland
Finland
Ukraine
Russia
China was not included in this question
93
91
48
42
93
89
82
81
80
58
92
46
54
7
2
53
38
19
43
15
10
48
Canada
USA
Chile
Colombia
India
Indonesia
Malaysia
Pakistan
Thailand
Egypt
Australia

27. 27
Search & Information
Behaviour

28. Finding out about Health
• Primary information sources are predictable HCPs, but
extent of consultation with less generalist physicians
varies very widely.
• Variation in online usage is enormous: British internet
use highly developed while Irish levels are much lower.
• Sites such as Wikipedia have enormous cachet.
28

29. Consulted In Past Year On Health Issues That Concern You Most
Used To Get Information On Health Issues That Concern You Most
Consulted in past year Used as way to get information
57
38
35
30
19
12
9
6
3
3
61
12
23
29
7
4
3
3
1
2
67
28
28
23
5
12
8
4
1
0
Own family GP in public
system
Specialists
Family & friends
Pharmacists
Other GPs/physicians
Others with the condition
Non-doctor healthcare
professionals
Social networking contacts
Spiritual/religious
Patient advocacy groups
51
26
24
21
19
8
7
6
3
2
2
37
11
12
12
13
1
4
4
2
1
*
71
13
14
25
14
3
4
5
5
*
1
Websites
TV/radio programme
Magazines or newspaper
Pamphlets in GP clinics
Books
Blogs/chatrooms
(Any) social media
Pamphlets mailed to you
Telephone information
lines
Smartphone apps
DVD/CDs
Global
Ireland
UK
The internet is a significant secondary source but much higher in some countries
(Germany & UK 71%, USA 79%, China 69%)
China (12%)

30. Secondary Sources by Region
Web-sites
TV or
radio
Magazi
nes or
newsp
apers
Brochures
from
physicians’
offices or
clinics Books
Blogs
and/or chat
rooms on
the internet
Social
media
(Facebook,
Twitter etc)
Global 51 26 24 21 19 8 7
India 7 51 33 7 21 1 2
China 69 61 47 23 53 23 25
Asia + Africa 40 46 38 23 23 9 18
Australia 70 14 14 28 18 8 5
East / Central
Europe
47 28 26 21 18 10 5
Western Europe 48 18 18 19 14 6 4
Americas 77 18 20 27 21 8 5

31. The Assertive
Patient
31

32. Input to Treatment
• Indicated as one of the significant coming trends.
• Desired control of own treatment more in evidence
where there are better treatment choices or options
(Netherlands).
• Evidently a middle aged, mid/upper class, affluent, better
educated phenomenon.
32

33. Patient Input into Treatment Decisions
You decide Work with physician Physician makes decision
11
9
7
7
6
8
5
2
9
10
6
23
8
16
6
14
8
51
79
75
75
69
64
63
62
61
54
53
51
49
48
40
30
28
35
11
17
17
24
26
31
33
28
35
37
26
28
32
53
53
64
All Countries
Hungary
Slovenia
Germany
France
Poland
Greece
Finland
UK
Ireland
Ukraine
Netherlands
Italy
Russia
Turkey
Lithuania
Romania
5
7
10
11
11
25
24
24
22
30
7
10
82
75
37
36
50
45
31
24
20
9
30
56
12
16
54
50
39
27
45
48
58
61
61
25
USA
Canada
Chile
Colombia
Thailand
Malaysia
China
Pakistan
Indonesia
India
Egypt
Australia

34. Actual & Perceived Health
34

35. Actual/Perceived Health Patterns
• Many feel that they are in good general health: perceived
health measures are strong.
• Claimed incidences of long term serious conditions vary
very substantially.
• Inter-relationship of perceived and actual health data
illustrates some broad relationships but equally some
more perplexing conundrums.
• We can categorise a First World Paradox of high
incidence/high health but equally the probability of
poorer detection (Ireland).
35

36. Perceived Personal Health Assessment
70
84
82
Excellent Good
73
72
72
72
72
69
69
63
63
57
56
56
54
53
14
33
9
12
12
17
15
15
12
20
6
8
11
6
15
12
5
All Countries
Ireland
Germany
Netherlands
Slovenia
Romania
France
Greece
UK
Lithuania
Italy
Finland
Hungary
Poland
Turkey
Ukraine
Russia
85
84
76
57
87
85
73
70
63
60
66
65
19
17
15
3
38
23
15
9
13
9
12
13
USA
Colombia
Canada
Chile
Pakistan
Indonesia
India
Malaysia
Thailand
China
Egypt
Australia

37. Top 5 Chronic Conditions by Region
16
14
11
11
10
8
5
8
10
9
5
4
5
6
4
4
5
2
2
1
5
5
6
3
4
4
3
4
5
7
2
3
2
1
Western Europe
Americas
Australia
East /Central Europe
China
Asia + Africa
India
High blood pressure High cholesterol Heart condition Diabetes Asthma

38. Chronic Conditions by Country (Top 5)
13
27
26
20
19
18
18
15
15
12
11
11
10
8
8
5
4
7
6
10
13
9
10
12
8
8
8
3
6
3
0
5
11
7
6
9
7
8
5
7
6
9
3
5
3
4
4
5
5
7
8
7
6
8
9
5
4
5
3
3
4
3
1
2
1
4
3
6
8
7
4
8
2
3
4
3
1
2
1
2
1
All Countries
Hungary
Germany
Finland
France
Turkey
Netherlands
Italy
Poland
UK
Russia
Slovenia
Romania
Greece
Lithuania
Ireland
Ukraine
20
16
10
5
19
10
9
5
4
3
6
11
15
13
4
3
13
4
1
0
3
2
1
9
6
4
3
0
5
2
1
1
1
1
1
4
8
6
4
1
9
4
2
3
3
1
4
6
10
3
3
1
4
3
1
4
1
1
7
Canada
USA
Chile
Colombia
Thailand
China
Pakistan
India
Malaysia
Indonesia
Egypt
Australia
High blood pressure High cholesterol Heart condition Diabetes Asthma

39. Actual & Perceived Health Contrast
HIGHER INCIDENCE
/POORER SELF
PERCEPTION
HIGHER INCIDENCE
/BETTER SELF
PERCEPTION
Turkey
Russia Poland
LOWER INCIDENCE
/POORER SELF
PERCEPTION
GLOBAL
AVERAGE
Germany
LOWER INCIDENCE
/BETTER SELF
PERCEPTION
33%
70%
Hungary
Finland
China
Chile
Thailand
Australia
Italy
UK
Greece
Ukraine
Egypt
Canada
France
Nederlands
USA
Slovenia
Romania
Malaysia
India
Colombia
Ireland
Pakistan
Indonesia
Lithuania
PERSONAL HEALTH
PERCEPTION
ANY
SERIOUS
ILLNESS
INCIDENCE

40. Key Thoughts
40

41. Key Thoughts
• Global variation in need but with much basic
commonality.
• Study helps to better illustrate global threats posed by
local ignorance and the need for better regulation.
• Transformative effect of online.
• The rise of the assertive patient.
• Differences in detection rates and in HCP use.
• Need for better PR for health systems.
41

42. Larry Ryan
Council Member, IRIS
Director, B&A
www.banda.ie