The Relative Importance of Quality of Care Information When Choosing a Hospital for Surgical Treatment

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

doi:10.1177/0272989x10386799

Cited by 64 publications

(16 citation statements)

References 18 publications

(14 reference statements)

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“…In addition, 29.4% of the urban residents and 26.5% of the rural residents rated good quality in medical care as a high priority in their reason for choosing medical institutions for the initial treatment, compared to other aspects of quality such as patient-physician communication. This supports the findings of a previous hospital choice experiment in which quality of care showed a relative higher importance than other factors such as hospital atmosphere and waiting time when choosing a hospital for surgical procedures[36]. This suggests that improving quality of services of PCFs will have a large impact on promoting the utilization rates of PCFs for the initial treatment, which may be particularly important for urban residents as a higher proportion of urban residents reported this factor as the principal reason for choosing medical institutions for the initial treatment.…”

Section: Discussionsupporting

confidence: 88%

Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China

Sun

Meng

et al. 2019

PLoS ONE

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ObjectiveTo explore influential factors contributing to the choice of primary care facilities (PCFs) for the initial treatment among rural and urban residents in Southwestern China.MethodsA face-to-face survey was conducted on a multistage stratified random sample of 456 rural and 459 urban residents in Sichuan Province from January to August in 2014. A structured questionnaire was used to collect data on residents’ characteristics, provider of initial treatment and principal reason for the choice. Multivariate logistic regression was performed to identify factors associated with choosing PCFs for the initial treatment.ResultsThe result showed that 65.4% of the rural residents and 50.5% of the urban residents chose PCFs as their initial contact for medical care. Among both rural and urban residents, the principal reason for choosing medical institutions for the initial treatment was convenience (42.3% versus 40.5%, respectively), followed by high quality of medical care (26.5% versus 29.4%, respectively). Compared to rural residents, urban residents were more likely to value trust in doctors and high quality of medical care but were less likely to value the insurance designation status of the facilities. Logistic regression analysis showed that both rural and urban residents were less likely to choose PCFs for the initial treatment if they lived more than 15 minutes (by walk) from the nearest facilities (rural: OR = 0.15, 95%CI = 0.09–0.26; urban: OR = 0.19, 95%CI = 0.10–0.36), had fair (rural: OR = 0.49, 95%CI = 0.26–0.92; urban: OR = 0.31, 95%CI = 0.15–0.64) or poor (rural: OR = 0.14, 95%CI = 0.07–0.30; urban: OR = 0.22, 95%CI = 0.11–0.44) self-reported health status. Among rural residents, attending college or higher education (OR = 0.21, 95%CI = 0.08–0.59), being retired (OR = 0.90, 95%CI = 0.44–1.84) and earning a per capita annual income of household of 10,000–29,999 (OR = 0.24, 95%CI = 0.11–0.52) and 30,000–49,999 (OR = 0.26, 95%CI = 0.07–0.92) were associated with lower rates of seeking care at PCFs.ConclusionEfforts should be made to improve the accessibility of PCFs and to upgrade the services capability of PCFs both in rural and urban areas in China. At the same time, resources should be prioritized to residents with poorer self-reported health status, and rural residents who retire or have better education and higher income levels should be taken into account.

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Section: Discussionsupporting

confidence: 88%

Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China

Sun

Meng

et al. 2019

PLoS ONE

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“…Survey data have suggested that patients selecting hospitals regarding where to obtain complex oncologic surgical care value surgeon, hospital, and procedure‐specific quality information 17,18 . In particular, patients with cancer are concerned about both short‐term technical (ie, no complications, no prolonged LOS, no readmission), as well as longer‐term oncological (ie, adequate staging, compliance with adjuvant therapy guidelines) goals of care.…”

Section: Discussionmentioning

confidence: 99%

“…Survey data have suggested that patients selecting hospitals regarding where to obtain complex oncologic surgical care value surgeon, hospital, and procedure-specific quality information. 17,18 In gastric, or colon cancers. 6,8,10 In the current study, the ability to achieve TOO was even lower among patients with PDAC as fewer than one in five patients had an "optimal" outcome.…”

Section: Discussionmentioning

confidence: 99%

Assessment of textbook oncologic outcomes following pancreaticoduodenectomy for pancreatic adenocarcinoma

Sweigert

Eguia

Baker

et al. 2020

Journal of Surgical Oncology

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Background Composite outcomes may more accurately reflect patient and provider expectations around optimal care. We sought to determine the impact of achieving a so‐called “textbook oncologic outcome” (TOO) among patients undergoing resection of pancreatic adenocarcinoma (PDAC). Methods Patients undergoing pancreaticoduodenectomy (PD) for PDAC between 2006 and 2016 were identified in the National Cancer Database (NCDB). TOO was defined by: margin negative resection, compliant lymph node evaluation, no prolonged length‐of‐stay, no 30‐day readmission/mortality, and receipt of adjuvant chemotherapy. Factors associated with TOO and overall survival (OS) were evaluated using multivariable logistic and Cox regression models, respectively. Results Among 18 608 patients who underwent PD at 782 hospitals, many patients successfully achieved certain TOO factors such as R0 margin (77.9%) and no 30‐day mortality (96.9%), while other TOO criteria such as receipt of adjuvant therapy (48.2%) were achieved less frequently. Overall, only 3124 (16.8%) patients achieved a TOO. Factors associated with lower odds of TOO included: older age, Black race, Medicaid insurance, Community facility, and low PD facility (<20 PD/y) (all P < .05). Achievement of a TOO was associated with lower risk of mortality (HR 0.74; 95% CI, 0.70‐0.77). Conclusions While TOO was associated with improved long‐term survival, TOO was only achieved in 16.8% of patients undergoing PD.

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“…The approach of TO is particularly suited for clinical interventions (surgery, invasive diagnostics) and was previously used in a study performed in the Netherlands in patients undergoing colon resection due to colon cancer. 6 The concept was also used in the form of a questionnaire in which patients reported their considerations in the choice of a hospital, 7 in patients with oesophagogastric cancer in need of surgery, 8 and elective aneurism surgery. 9 However none of these studies used existing data primarily used for reimbursement.…”

Section: Introductionmentioning

confidence: 99%

Is Textbook Outcome a valuable composite measure for short-term outcomes of gastrointestinal treatments in the Netherlands using hospital information system data?A retrospective cohort study

Salet

Bremmer²,

Verhagen

et al. 2018

BMJ Open

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ObjectiveTo develop a feasible model for monitoring short-term outcome of clinical care trajectories for hospitals in the Netherlands using data obtained from hospital information systems for identifying hospital variation.Study designRetrospective analysis of collected data from hospital information systems combined with clinical indicator definitions to define and compare short-term outcomes for three gastrointestinal pathways using the concept of Textbook Outcome.Setting62 Dutch hospitals.Participants45 848 unique gastrointestinal patients discharged in 2015.Main outcome measureA broad range of clinical outcomes including length of stay, reintervention, readmission and doctor–patient counselling.ResultsPatients undergoing endoscopic retrograde cholangiopancreatography (ERCP) for gallstone disease (n=4369), colonoscopy for inflammatory bowel disease (IBD; n=19 330) and colonoscopy for colorectal cancer screening (n=22 149) were submitted to five suitable clinical indicators per treatment. The percentage of all patients who met all five criteria was 54%±9% (SD) for ERCP treatment. For IBD this was 47%±7% of the patients, and for colon cancer screening this number was 85%±14%.ConclusionThis study shows that reusing data obtained from hospital information systems combined with clinical indicator definitions can be used to express short-term outcomes using the concept of Textbook Outcome without any excess registration. This information can provide meaningful insight into the clinical care trajectory on the level of individual patient care. Furthermore, this concept can be applied to many clinical trajectories within gastroenterology and beyond for monitoring and improving the clinical pathway and outcome for patients.

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The Relative Importance of Quality of Care Information When Choosing a Hospital for Surgical Treatment

Abstract: Surgery-specific and quality of care information are more important than general information when patients choose between hospitals.

Cited by 64 publications

References 18 publications

Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China

Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China

Assessment of textbook oncologic outcomes following pancreaticoduodenectomy for pancreatic adenocarcinoma

Is Textbook Outcome a valuable composite measure for short-term outcomes of gastrointestinal treatments in the Netherlands using hospital information system data?A retrospective cohort study

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