Comparative Quality Indicators for Hospital Choice: Do General Practitioners Care?

Ferrua, Marie; Sicotte, Claude; Lalloué, Benoît; Minvielle, Étienne

doi:10.1371/journal.pone.0147296

Cited by 16 publications

(11 citation statements)

References 23 publications

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“…Very few of the GPs that contributed to this study had heard of MyHospitals or other sources of PPR, and one had considered using MyHospitals when making patient referrals to public hospitals. These findings are consistent with past studies conducted in Europe which also found that despite the availability of PPR of hospital data, it was little utilised for hospital referrals by GPs [ 14 , 23 – 25 ]. Despite the different healthcare systems, the similar findings are largely attributed to the lack of awareness about PPR information among GPs.…”

Section: Discussionsupporting

confidence: 92%

“…There has been little research examining whether the availability of PPR of hospital data influences GPs’ referral behaviours; the majority of the PPR literature focusses on consumers and healthcare providers such as surgeons and hospitals [ 8 , 21 , 22 ]. Among the few studies conducted in Europe, researchers have found that GPs never or rarely used PPR information when referring patients to hospitals [ 14 , 23 – 25 ]. Instead, GPs relied mostly on informal sources of information such as: distance to the hospital; feedback from patients and colleagues; prior experience; and personal contacts with medical specialists, departments or hospitals [ 14 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

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The use of public performance reporting by general practitioners: a study of perceptions and referral behaviours

et al. 2018

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BackgroundPublic performance reporting (PPR) of hospital data aims to improve quality of care in hospitals and to inform consumer choice. In Australia, general practitioners (GPs) are gatekeepers to secondary care with patients requiring their referral for non-emergency access. Despite their intermediary role, GPs have been generally overlooked as potential users of PPR of hospital data, with the majority of the PPR research focussing on consumers, surgeons and hospitals.MethodsWe examined the use of PPR of hospital data by GPs when referring patients to hospitals. Semi-structured interviews were conducted with 40 GPs, recruited via the Victorian Primary Care Practice-Based Research Network and GP teaching practices in Victoria, Australia. The interviews were recorded, transcribed and analysed thematically.ResultsWe found that the majority of GPs did not use PPR when referring patients to hospitals. Instead, they relied mostly on informal sources of information such as their own or patients’ previous experiences. Barriers that prevented GPs’ use of PPR in their decision making included: lack of awareness and accessibility; perceived lack of data credibility; restrictive geographical catchments for certain hospitals; limited choices of public hospitals in regional and rural areas; and no mandatory PPR for private hospitals.ConclusionsOur findings suggest that lack of PPR awareness prevented GPs from using it in their referral practice. As gatekeepers to secondary care, GPs are in a position to guide patients in their treatment decisions and referrals using available PPR data. We suggest that there needs to be greater involvement by GPs in the development of hospital performance and quality indicators in Australia if GPs are to make greater use of them. The indicators require further development before GPs perceive them as valid, credible, and of use for informing their referral practices.Electronic supplementary materialThe online version of this article (10.1186/s12875-018-0719-4) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The use of public performance reporting by general practitioners: a study of perceptions and referral behaviours

et al. 2018

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“…Two decades later, despite an almost universal awareness of cardiac surgeon report cards, their impact on referral practices still remains limited [ 13 ]. Also, recent evidence from France [ 14 ] and the Netherlands [ 15 ] backs up those findings. The issue of whether and how physicians use publicly reported hospital quality information for referring patients to hospitals in Germany has yet to be addressed.…”

Section: Introductionmentioning

confidence: 66%

“…For example, Ferrua et al surveyed 503 self-employed general practitioners in private practice in France. They showed that approximately 14% of the practitioners had already used publicly available comparative indicators to influence hospital choices for their patients [ 14 ]. Similar results have also been shown in the Netherlands.…”

Section: Discussionmentioning

confidence: 99%

Public release of hospital quality data for referral practices in Germany: results from a cluster-randomised controlled trial

et al. 2017

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ObjectiveTo evaluate the impact of different dissemination channels on the awareness and usage of hospital performance reports among referring physicians, as well as the usefulness of such reports from the referring physicians’ perspective.Data sources/Study settingPrimary data collected from a survey with 277 referring physicians (response rate = 26.2%) in Nuremberg, Germany (03–06/2016).Study designCluster-randomised controlled trial at the practice level. Physician practices were randomly assigned to one of two conditions: (1) physicians in the control arm could become aware of the performance reports via mass media channels (Mass Media, =132, =147); (2) physicians in the intervention arm also received a printed version of the report via mail (Mass and Special Media, =117; =130).Principal findingsOverall, 68% of respondents recalled hospital performance reports and 21% used them for referral decisions. Physicians from the Mass and Special Media group were more likely to be aware of the performance reports (OR 4.16; 95% CI 2.16–8.00, p < .001) but not more likely to be influenced when referring patients into hospitals (OR 1.73; 95% CI 0.72–4.12, p > .05). On a 1 (very good) to 6 (insufficient) scale, the usefulness of the performance reports was rated 3.67 (±1.40). Aggregated presentation formats were rated more helpful than detailed hospital quality information.ConclusionsHospital quality reports have limited impact on referral practices. To increase the latter, concerns raised by referring physicians must be given more weight. Those principally refer to the underlying data, the design of the reports, and the lack of important information.Electronic supplementary materialThe online version of this article (doi: 10.1186/s13561-017-0171-5) contains supplementary material, which is available to authorized users.

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“…Verschiedene Studien belegen ebenso die große Bedeutung einer hohen medizinischen Qualität der Behandlung für einweisende Ärzte und Patienten für die Empfehlung bzw. Wahl einer Klinik [3][4][5][6].…”

Section: Hinführungunclassified

Objektive oder subjektive Qualität?

Raab

Fischer

Mauler

2020

Gesundheitsökonomie & Qualitätsmanagement

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Zusammenfassung Zielsetzung Der vorliegende Artikel befasst sich mit der Überprüfung möglicher Zusammenhänge zwischen Kriterien der Behandlungsqualität, der Zufriedenheit und der Weiterempfehlung von Patienten einer Akutklinik mittels statistischer Verfahren. Methodik Datengrundlage bilden QSR-Daten (Qualitätssicherung mit Routinedaten) und Ergebnisse des PEQ (Patients’ Experience Questionnaire) aus dem AOK Krankenhausnavigator am Beispiel der Prozedur „Einsetzen eines künstlichen Kniegelenks“. Die Analyse und Interpretation der online gewonnenen Daten erfolgt mithilfe des Statistikprogramms SPSS unter Anwendung deskriptiver und induktiver Statistik. Ergebnisse ▪ Geringer signifikanter Zusammenhang der Kriterien der Behandlungsqualität und der Gesamtzufriedenheit der Patienten. ▪ Schwacher Einfluss der Behandlungsqualität auf die Weiterempfehlung der Patienten. ▪ Kliniken mit überdurchschnittlicher Qualität erreichen höchste Weiterempfehlungsquoten. Kliniken mit unterdurchschnittlicher Qualität erzielen signifikant bessere Ergebnisse hinsichtlich Weiterempfehlung als Kliniken mit durchschnittlicher Qualität. ▪ Zufriedenheit mit ärztlicher Versorgung sowie Zufriedenheit mit Organisation und Service haben großen Einfluss auf die Weiterempfehlung aus Patientensicht. Schlussfolgerung Objektive Qualitätsmerkmale der Klinik haben nur geringe Auswirkungen auf die Weiterempfehlung einer Klinik durch den Patienten. Relevant sind subjektiv wahrgenommene Merkmale wie die Zufriedenheit mit ärztlicher Versorgung oder die Zufriedenheit mit Organisation und Service. Bereitgestellte Qualitätsberichte müssen patientengerecht gestaltet werden bspw. durch die Ergänzung von für den Patienten relevanten Informationen wie Patient Reported Outcomes (PRO).

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Comparative Quality Indicators for Hospital Choice: Do General Practitioners Care?

Cited by 16 publications

References 23 publications

The use of public performance reporting by general practitioners: a study of perceptions and referral behaviours

The use of public performance reporting by general practitioners: a study of perceptions and referral behaviours

Public release of hospital quality data for referral practices in Germany: results from a cluster-randomised controlled trial

Objektive oder subjektive Qualität?

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