Public reporting of hospital quality data: What do referring physicians want to know?

Geraedts, Max; Hermeling, Peter; Ortwein, Annette; Cruppé, Werner de

doi:10.1016/j.healthpol.2018.09.010

Cited by 15 publications

(16 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Clinical outcome indicators, on the contrary, are rather difficult to interpret for medical laypersons. Nevertheless, as patients often rely on their referring outpatient physician's professional opinion [29] and outpatient physicians strongly value high clinical quality [30], we expect some effects from better clinical outcome to affect patient's hospital choice.…”

Section: Accessibility and Comprehensibilitymentioning

confidence: 99%

The impact of quality on hospital choice. Which information affects patients’ behavior for colorectal resection or knee replacement?

Kuklinski

Vogel

Geißler

2021

Health Care Manag Sci

View full text Add to dashboard Cite

Quality competition among hospitals, induced by patients freely choosing their hospital in a price regulated market, can only be realized if quality differences between hospitals are transparent, understandable, and thus influence patients’ hospital choice. We use data from ~145,000 German patients and ~ 900 hospitals for colorectal resections and knee replacements to investigate whether patients value quality and specialization when choosing their hospital. Using a random utility choice model, we estimate patients’ marginal utilities, willingness to travel and change in hospital demand for quality improvements. Patients respond to service quality and specialization and thus, quality competition seems to be present. Colorectal resection patients are willing to travel longer for more specialized hospitals (+9% for procedure volume, +9% for certification). Knee replacement patients travel longer for hospitals with better service quality (+6%) and higher procedure volume (+12%). However, clinical quality indicators, often difficult to access and interpret, barely play a role in patients’ hospital choice. Furthermore, we find that competition on quality for colorectal resection is rather local, whereas for knee replacement we observe regional competition patterns.

show abstract

Section: Accessibility and Comprehensibilitymentioning

confidence: 99%

The impact of quality on hospital choice. Which information affects patients’ behavior for colorectal resection or knee replacement?

Kuklinski

Vogel

Geißler

2021

Health Care Manag Sci

View full text Add to dashboard Cite

show abstract

“…First, the role of competition among hospitals in breast cancer care is limited through the rare use of selective contracting by health purchasers in the Netherlands 43. Additionally, hospital competition in this market does also not seem to be strengthened by active patient choice 44. Recent research suggested that most breast cancer patients agreed on being referred to the nearest hospital by their general practitioner 45.…”

Section: Discussionmentioning

confidence: 99%

Associations of hospital volume and hospital competition with short-term, middle-term and long-term patient outcomes after breast cancer surgery: a retrospective population-based study

et al. 2022

View full text Add to dashboard Cite

ObjectivesFor oncological care, there is a clear tendency towards centralisation and collaboration aimed at improving patient outcomes. However, in market-based healthcare systems, this trend is related to the potential trade-off between hospital volume and hospital competition. We analyse the association between hospital volume, competition from neighbouring hospitals and outcomes for patients who underwent surgery for invasive breast cancer (IBC).Outcome measuresSurgical margins, 90 days re-excision, overall survival.Design, setting, participantsIn this population-based study, we use data from the Netherlands Cancer Registry. Our study sample consists of 136 958 patients who underwent surgery for IBC between 2004 and 2014 in the Netherlands.ResultsOur findings show that treatment types as well as patient and tumour characteristics explain most of the variation in all outcomes. After adjusting for confounding variables and intrahospital correlation in multivariate logistic regressions, hospital volume and competition from neighbouring hospitals did not show significant associations with surgical margins and re-excision rates. For patients who underwent surgery in hospitals annually performing 250 surgeries or more, multilevel Cox proportional hazard models show that survival was somewhat higher (HR 0.94). Survival in hospitals with four or more (potential) competitors within 30 km was slightly higher (HR 0.97). However, this effect did not hold after changing this proxy for hospital competition.ConclusionsBased on the selection of patient outcomes, hospital volume and regional competition appear to play only a limited role in the explanation of variation in IBC outcomes across Dutch hospitals. Further research into hospital variation for high-volume tumours like the one studied here is recommended to (i) use consistently measured quality indicators that better reflect multidisciplinary clinical practice and patient and provider decision-making, (ii) include more sophisticated measures for hospital competition and (iii) assess the entire process of care within the hospital, as well as care provided by other providers in cancer networks.

show abstract

“…When physicians are presented with options for public reporting of data, most preferred at least some numeric data be included when data about quality are presented publicly. 27,28 In contrast, efforts to increase the patients' use of publicly reported quantitative quality metrics (e.g., process measures and results from patient experience surveys) have, for the most part, failed to demonstrate increases in uptake. 7,29 And, when given the option to read narratives, patients prefer them over quantitative data.…”

Section: Discussionmentioning

confidence: 99%

Physician Beliefs About Online Reporting of Quality and Experience Data

et al. 2019

View full text Add to dashboard Cite

IMPORTANCE: Physician attitudes about websites that publicly report health care quality and experience data have not been recently described. OBJECTIVES: To examine physician attitudes about the accuracy of websites that report information about quality of care and patient experience and to describe physician beliefs about the helpfulness of these data for patients choosing a physician. DESIGN, PARTICIPANTS, AND MEASURES: The Rhode Island Department of Health (RIDOH) and a multistakeholder group developed and piloted two questions that were added to RIDOH's biennial physician survey of all 4197 practicing physicians in Rhode Island: (1) "How accurate of a picture do you feel that the following types of online resources give about the quality of care that physicians provide?" (with choices) and (2) "Which types of physician-specific information (i.e., not about the practice overall) would be helpful to include in online resources for patients to help them choose a new physician? (Select all that apply)." Responses were stratified by primary care vs. subspecialty clinicians. Summary statistics and chisquared tests were used to analyze the results. RESULTS: Among 1792 respondents (response rate 43%), 45% were unaware of RIDOH's site and 54% were unaware of the Centers for Medicare & Medicaid Services (CMS)' quality reporting sites. Only 2% felt that Medicare sites were "very accurate" in depicting physician quality. Most physicians supported public reporting of general information about physicians (e.g., board certification), but just over one-third of physicians felt that performance-based quality measures are "helpful" (and a similar percentage reported that patient reviews felt are "helpful") for patients choosing a physician. CONCLUSIONS: Physician-respondents were either uninformed or skeptical about public reporting websites. In contrast to prior reports that a majority of patients value some forms of publicly reported data, most physicians do not consider quality metrics and patient-generated reviews helpful for patients who are choosing a physician.

show abstract

Public reporting of hospital quality data: What do referring physicians want to know?

Cited by 15 publications

References 41 publications

The impact of quality on hospital choice. Which information affects patients’ behavior for colorectal resection or knee replacement?

The impact of quality on hospital choice. Which information affects patients’ behavior for colorectal resection or knee replacement?

Associations of hospital volume and hospital competition with short-term, middle-term and long-term patient outcomes after breast cancer surgery: a retrospective population-based study

Physician Beliefs About Online Reporting of Quality and Experience Data

Contact Info

Product

Resources

About