Patient hospital choice for hip replacement: empirical evidence from the Netherlands

Abstract

In the Dutch health care system, hospitals are expected to compete. A necessary condition for competition among hospitals is that patients do not automatically choose the nearest hospital, but are-at least to some extent-sensitive to differences in hospital quality. In this study, an analysis is performed on the underlying features of patient hospital choice in a setting where prices do not matter for patients as a result of health insurance coverage. Using claims data from all Dutch hospitals over the years 2008-2010, a conditional logit model examines the relationship between patient characteristics (age, gender and reoperations) and hospital attributes (hospital quality information, waiting times on treatments and travel time for patients to the hospitals) in the market for general non-emergency hip replacement treatments. The results show that travel time is the most important determinant in patient hospital choice. From our analysis, however, it follows that publicly available hospital quality ratings and waiting times also have a significant impact on patient hospital choice. The panel data used for this study (2008-2010) is rather short, which may explain why no coherent and persistent changes in patient hospital choice behaviour over time are found.

Patient choice modelling: how do patients choose their hospitals?

“…This agrees with the results of the majority of previous studies (see e.g. [5,33]). It is also worth emphasizing here that we are working with a large, comprehensive data set that includes admissions data for all hospital departments in a region that incorporates both urban and rural areas, rather than focusing on just one specialty as other authors have done (e.g.…”

“…RP data from the Netherlands are used in [37] and [5], and from the UK in [2], all of which focus mainly on choice of orthopaedic care. Several hospital choice studies use similar data to ours, hospital discharge records, but in a United States setting [10,24], and [35] use Medicare claims data.…”

The Impact of the eHealth Technologies on the Chronically-ill Patient�s choice of Same Hospital Again (Preprint)

“…Higher quality of treatment by a hospital can significantly improve the possibility of choosing the hospital again. It shows that high-quality treatment level is the most important determinant in patients' choices of hospital, which is a different outcome than that provided by some of the literature [25]. However, this result is not surprising in China.…”

“…Therefore, the application of eHealth will greatly increase the tendency of patients to choose the hospital that is associated with a high degree of convenience (e.g. close distance, convenient medical appointment, efficient treatment process) [25]. Meanwhile, eHealth technologies ' narrows the differences in treatment levels provided between hospitals.…”

“…Beukers and Kemp [25] examined the relationship between the convenience of the hospital for the patient and hospital choice by means of a conditional logit model. They found that travel time is the most important factor affecting the hospital choice of a patient.…”