The importance of experienced adverse outcomes on patients' future choice of a hospital for surgery

Mheen, Perla J Marang-van de; Dijs-Elsinga, J.; Otten, W.; Versluijs, Martine M.; Smeets, H.J.; Vree, R.; Kievit, J.

doi:10.1136/qshc.2008.031690

Cited by 21 publications

(31 citation statements)

References 14 publications

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“…However, most studies investigating real choices found that outcome indicators have a limited influence on patients’ choices. This difference is confirmed by research that directly compared revealed preferences against stated preferences [30,45,46,48,49]. Exceptions are results from studies analysing patient registration data.…”

Section: Discussionmentioning

confidence: 89%

“…Often, patients who do find this information relevant eventually do not use it, which suggests that there is a difference between what patients say and what they actually do [16,31,64]. This difference is confirmed by research that directly compared revealed preferences against stated preferences [30,45,46,48,49]. Patients use more comparative information in future choices and in advice to others than they used in previous choices.…”

Section: Resultsmentioning

confidence: 99%

“…Generally, other characteristics are found to be more important than outcome, such as GP referral and distance [16,30,41,46,64,67]. Differences in the importance attached to outcome indicators are partly explained by the differences between the characteristics that patients say are important and the ones they act upon in a real choice situation.…”

Section: Resultsmentioning

confidence: 99%

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Determinants of patient choice of healthcare providers: a scoping review

Victoor

Delnoij

Friele

et al. 2012

BMC Health Serv Res

393

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BackgroundIn several northwest European countries, a demand-driven healthcare system has been implemented that stresses the importance of patient healthcare provider choice. In this study, we are conducting a scoping review aiming to map out what is known about the determinants of patient choice of a wide range of healthcare providers. As far as we know, not many studies are currently available that attempt to draw a general picture of how patients choose a healthcare provider and of the status of research on this subject. This study is therefore a valuable contribution to the growing amount of literature about patient choice.MethodsWe carried out a specific type of literature review known as a scoping review. Scoping reviews try to examine the breadth of knowledge that is available about a particular topic and therefore do not make selections or apply quality constraints. Firstly, we defined our research questions and searched the literature in Embase, Medline and PubMed. Secondly, we selected the literature, and finally we analysed and summarized the information.ResultsOur review shows that patients’ choices are determined by a complex interplay between patient and provider characteristics. A variety of patient characteristics determines whether patients make choices, are willing and able to choose, and how they choose. Patients take account of a variety of structural, process and outcome characteristics of providers, differing in the relative importance they attach to these characteristics.ConclusionsThere is no such thing as the typical patient: different patients make different choices in different situations. Comparative information seems to have a relatively limited influence on the choices made by many patients and patients base their decisions on a variety of provider characteristics instead of solely on outcome characteristics. The assumptions made in health policy about patient choice may therefore be an oversimplification of reality. Several knowledge gaps were identified that need follow-up research.

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Section: Discussionmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Determinants of patient choice of healthcare providers: a scoping review

Victoor

Delnoij

Friele

et al. 2012

BMC Health Serv Res

393

View full text Add to dashboard Cite

show abstract

“…16 It can be hypothesized that the attribute percentage of patients with "textbook outcomes" has greater impact on patients' choices if they have experienced adverse outcomes, as the occurrence of adverse outcomes is part of this attribute. We therefore assessed whether the relative importance patients assigned to this attribute differed between patients with and without adverse outcomes during their initial hospitalization or after discharge, using oneway analysis of variance with post hoc Bonferroni or Tamhane tests for multiple comparisons.…”

Section: Analysesmentioning

confidence: 99%

The Relative Importance of Quality of Care Information When Choosing a Hospital for Surgical Treatment: A Hospital Choice Experiment

Mheen¹,

Dijs-Elsinga²,

Otten³

et al. 2011

Medical Decision Making

Self Cite

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Objective:To assess the impact of quality of care and other hospital information on patients' choices between hospitals. Methods: 665 former surgical patients were invited to respond to an Internet-based questionnaire including a choice-based conjoint analysis. Each patient was presented with 12 different comparisons of 2 hospitals, with each hospital characterized by 6 attributes containing 2 levels. Hospital attributes were included if frequently reported by patients as most important for future hospital choices. These included both general hospital information (e.g., atmosphere), information on quality of care (e.g., percentage of patients with "textbook outcome"), and surgery-specific information (e.g., possibility for minimally invasive procedure). Hierarchial Bayes estimation was used to estimate the utilities for each attribute level for each patient. Based on the ranges of these utilities, the relative importance of each hospital attribute was determined for each participant as a measure of the impact on patients' choices. Results: 308 (46.3%) questionnaires were available for analysis. Of the hospital attributes that patients considered, surgery-specific information on average had the highest relative importance (25.7 [23.9-27.5]), regardless of gender, age, and education. Waiting time and hospital atmosphere were considered least important. The attribute concerning the percentage of patients with "textbook outcomes" had the second greatest impact (18.3 [16.9-19.6]), which was similar for patients with different adverse outcome experience. Conclusions: Surgery-specific and quality of care information are more important than general information when patients choose between hospitals. I nformation on performance of hospitals is increasingly available within the public domain in various countries worldwide. 1 Such information is thought to improve patients' choice and quality of care. However, patients do not seem to use quality information for their hospital choice. Marshall and others, 2 for instance, showed in their literature review of the period 1986-1999 that patients rarely searched for information about hospital performance, that they did not understand or trust information they did find, and that it had a small (although increasing during the time period reviewed) impact on their decision making. More recently, Faber and others 3 concluded in their systematic review that there is limited evidence about the effectiveness of quality information on consumer choice. Furthermore, Fung and others 4 showed in their review that the effect of public reporting on the outcomes of patient care, improvement of patient safety, and patient centeredness remains uncertain, since rigorous evaluation of many reporting systems is lacking. Possible explanations for these findings are that there is too much information, it is not the information patients want, or other information prevails when choices are made.Increased competition between hospitals based on quality is one of the central themes in the health care insur...

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“…In contrast to most previous studies, this study focuses on possibilities to empower patients to take active choices, in particular by bringing in the concept of targeted transparency taken from Fung, Graham & Weil's book "Full Disclosure" (2007). Many scholars have invested a lot of time and effort into assessing whether and how patients in the Netherlands are using PQR tools with interviews Damman et al, 2009;de Groot et al, 2010;Marang-van de Mheen et al, 2010;Moser et al, 2010;Ketelaar et al, 2014;Victoor et al, 2014). However, all of these contributions only provided, if at all, a discussion of their findings in the light of studies from the USA or the UK.…”

Section: Gaps In Existing Researchmentioning

confidence: 99%