Georgia Health Decisions was founded in 1991 by a group of individuals concerned about the rising cost and lack of access to affordable health services.  Members pledged to come together as unbiased individuals, leaving professional and institutional affiliations aside, to form Georgia Health Decisions as a non-profit, non-partisan organization designed strictly to reflect the voices of the people of Georgia regarding health related issues.

The mission of Georgia Health Decisions is to educate Georgians about health care issues and to understand and articulate Georgians opinions, attitudes and values on health care issues.  Our goal is to understand Georgians’ health care values through public discussion and scientifically valid research.  Such values represent the criteria against which health care systems should be evaluated in terms of meeting the expectations and the expressed will of the people of Georgia.   Since its institution, Georgia Health Decisions has successfully sought to understand and report Georgians’ attitudes on a variety of important health care issues.  Using an innovative, integrated approach to public research, Georgia Health Decisions engages individuals in constructive dialogue and positive deliberation through the use of focus groups, citizen panels, community forums, conferences, retreats and workshops, media campaigns, and informational presentations.

The projects described on the following pages are representative examples of those undertaken by Georgia Health Decisions since 1991.

CRITICAL Conditions^SM

CRITICAL Conditions^SM is a community-wide educational program designed by Georgia Health Decisions to help people better understand and plan for their health care at the end of life.  The program and materials were created following extensive focus group research across the country and in Georgia to understand the opinions, attitudes and values people have about health care at the end of life.  CRITICAL Conditions^SM seeks to make it easier for individuals and their loved ones to talk about final health care decisions.  The program provides information and materials to guide families through this difficult discussion and put their wishes in writing.
 
The CRITICAL Conditions^SM program includes a series of materials and programs that facilitate final health care discussion.  The CRITICAL Conditions^SM Planning Guide was designed to help Georgians have conversations about and document their final health care choices and decisions through a three step process. 

GEORGIANS ATTITUDES REGARDING HEALTH, THE UNINSURED AND OTHER HEALTH ISSUES: FINDINGS FROM FOCUS GROUPS WITH SELECTED GEORGIA DEMOGRAPHIC CLUSTERS

Georgia Health Decisions worked with the Georgia Health Policy Center on this qualitative research study which sought to identify  and describe issues of health care access and health insurance coverage, discover attitudes about universal health coverage and access to health services, understand perceptions of quality of health care services received by participants, explore participants’ knowledge regarding healthy living and gather personal assessments of healthy lifestyles and understand Georgians’ awareness of, experience with and attitudes toward Georgia’s PeachCare program.  A total of 114 focus group participants from 12 counties attended 12 focus group discussions.

ATTITUDES OF SCHOOL EMPLOYEES ON HEALTHY LIVING: INSIGHTS FOR DEVELOPING LEARNING LABS IN ALBANY AND ROME, GEORGIA

In collaboration with the Live Healthy Georgia Campaign, Georgia Health Decisions participated in a multi-faceted program to solicit and engage Ambassadors for a Live Healthy Georgia Learning Lab Project in two pilot communities in Georgia.  The goal of the project was to promote workplace wellness in the school environment.  The two communities selected for the Live Healthy Georgia Learning Lab Project were Dougherty County/City of Albany and Floyd County/City of Rome.  Georgia Health Decisions identified and recruited Live Healthy Georgia Ambassadors from a cross-section of employees in the two school systems, coordinated and conducted six facilitated discussions with Ambassadors in each community, interviewed the principals of the pilot schools, and coordinated a Live Health Georgia Ambassador Celebration in each community.  The purpose of these activities was to set the stage for a program that will successfully promote health and wellness in the school workplace.

COVERING THE UNINSURED: A COMMUNITY PERSPECTIVE

Georgia Health Decisions conducted thirty community forums in 27 Georgia counties with the goal of educating and engaging business and community leaders in discussions about options for covering the 1.5 million people in the state of Georgia who lack health insurance coverage.  This research was conducted on behalf of the Governor’s Office of Planning and Budget under a State Health Planning Grant awarded by the federal Health Resources and Services Administration, as part of an ongoing research initiative to study the problem in Georgia.  Four hundred forty-five (445) people participated in the community forums.  During the community forums, participants were asked to rank seven options for covering the uninsured; listen to findings about health status, health care costs and insurance coverage in Georgia, the profile of Georgia’s population, and trade-offs regarding each of the seven coverage options; engage in a facilitated discussion to gauge the impact of the factual information presented, and re-rank the seven options to track changes, if any, in participants’ preferences for covering the uninsured. Through this sequence, Georgia Health Decisions learned about community members’ preferences for covering the uninsured and gauged the impact that relevant factual information had on those preferences.

GEORGIANS ATTITUDES ON PROVIDING COVERAGE FOR THE UNINSURED

Georgia Health Decisions worked with the Governor's Office of the Consumers' Insurance Advocate and the Georgia Health Policy Center on the Georgia Healthcare Coverage Project funded by a grant from the Health Resources and Services Administration.  Georgia Health Decisions conducted 21 focus groups to identify Georgians' opinions and attitudes regarding expanding insurance coverage for the state's 1.3 million uninsured individuals.   Six focus groups also were conducted with small business owners to discuss their experiences in providing health insurance for their employers and ascertain their support for various options for covering the uninsured.

A SILENT ANGUISH: RECOGNIZING THE NEEDS OF DYING PATIENTS AND THEIR FAMILIES

This report captures the experiences and attitudes of family members of patients who died in a hospital setting in Georgia.  Family members were solicited from the next-of-kin lists provided by eight hospitals across the state.  The deaths of 100 individuals were represented by those who attended the eleven focus groups conducted by Georgia Health Decisions.  Most of the patients experienced chronic, long-term illnesses, while a few had died suddenly or following an illness of a short duration.  Participants were asked to discuss a range of topics related to their loved ones' illnesses and the healthcare their loved ones had received during the course of their illnesses.  The report clearly identifies a number of areas that require attention in order to improve the dying experience within a hospital setting.

THE QUEST TO DIE WITH DIGNITY

Georgia Health Decisions, in conjunction with American Health Decisions was asked by the Robert Wood Johnson Foundation to identify Americans’ values, opinions and attitudes about health care at the end of life. Thirty-six focus groups were conducted in two tiers: twelve focus groups were held with a cross-section of Americans in rural and urban locations throughout the country; and, twenty-four focus groups were held with individuals of like ethnicity, age, and religious affiliation.  The two-tiered approach ensured that the opinions of Americans who might have distinct attitudes and experiences concerning end-of-life issues were clearly heard and understood.  To further include those with unique opinions on these issues, twenty-nine one-on-one telephone interviews were completed with terminally ill individuals or individuals who had recently lost a loved one to a terminal illness.  Analysis of the focus group and one-on-one interview transcripts provided a clear understanding of Americans’ views on the dying process within our health care system.  The values underlying Americans’ attitudes on health care at the end of life were articulated and recommendations for improving the health care system to respond to those values were developed.

EVALUATION OF THE CHILDREN'S HEALTH INSURANCE AND MEDICAID PROGRAMS IN GEORGIA AND ALABAMA

Georgia Health Decisions worked with the Rollins School of Public Health at Emory University and the University of Alabama at Birmingham on an evaluation of the Children's Health Insurance Programs in Georgia and Alabama.  Georgia Health Decisions role in this project was to conduct focus group research with both beneficiaries and providers.  Thirty-six focus groups were conducted with parents of CHIP enrollees in both states, parents of Medicaid beneficiaries in both states, and physicians who serve these populations in both states. At the completion of the focus groups, Georgia Health Decisions analyzes transcripts and prepared a report of the findings.

ATTITUDES AND OPINIONS OF GEORGIANS WITH RURAL HEALTH SERVICES

The Georgia Networks for Rural Health is charged with the responsibility for assisting rural communities in sustaining and developing appropriate health care services to meet the needs of rural Georgians.  To assist in this effort, Georgia Health Decisions conducted 32 focus groups with Georgians who live in rural counties.   Participants discussed their attitudes about services available in rural communities, their utilization of such services and their views about what health services are essential for rural communities.   Specific focus groups were conducted with participants from each of the following categories:  privately insured, uninsured, Medicaid beneficiaries and Medicare beneficiaries.  Through this research, Georgia Health Decisions was able to provide insights into how rural Georgians feel about health services in their community and what changes are necessary to increase utilization of rural health services.

GEORGIANS’ VIEWS ON MEDICAID

Governor Zell Miller and the Commissioner of the Department of Medical Assistance asked the Georgia Coalition for Health to study the state's Medicaid program and provide recommendations for changing the system.  In turn, Georgia Health Decisions structured a project to understand Georgians’ attitudes about Medicaid. Thirty-six focus groups were conducted across the state with randomly recruited participants. In addition to the focus groups with randomly selected citizens eleven more focus groups were held with only Medicaid beneficiaries.  Some of these groups included a cross-section of beneficiaries randomly recruited from lists provided by the Department of Medical Assistance and some kept specific groups of beneficiaries together, such as low-income mothers or beneficiaries with disabilities.  Finally, six focus groups were held with health care providers to obtain their reactions, insights, and input on changes to the Medicaid program.

Through this research, Georgia Health Decisions discovered how typical Georgians and Medicaid beneficiaries work through this complicated health care issue, what priorities they set, what compromises they are willing to make, and what reform measures they would most likely support.

GEORGIANS’ VIEWS ON HEALTH CARE SERVICES

In support of the Georgia Coalition for Health’s efforts to develop recommendations for establishing health insurance purchasing cooperatives, Georgia Health Decisions conducted research with Georgians to identify which health care services they would include in a standard benefits package. Sixteen focus groups each were held with where participants were presented with an expanded list of health services, given information about the relative cost of each service, and then asked to develop a standard benefits package that would meet the needs of most Georgians.  The standard benefits package emerging from the focus groups and citizen panels was tested in ten focus groups of demographically mixed Georgians to gain insights into how the larger public would react to the package.

GEORGIANS SPEAK OUT ON HEALTH CARE

Georgia Health Decisions was founded on the principle that Georgians’ values should be the basis for shaping our health care system. Therefore, the organization’s first undertaking was to identify and understand those values.  To accomplish this goal, Georgia Health Decisions conducted the most comprehensive research ever undertaken in Georgia to understand citizens' underlying values on a public policy issue.  This three-year effort included over 70 focus groups, 250 community forums, and four citizen panels. Through these steps, Georgia Health Decisions was able to clearly articulate the health care values of Georgians and demonstrate how these values can be used to both define the health care system. The resulting report, Georgians Speak Out on Health Care, continues to serve as a measure of Georgians' expectations for their health care system.