Different patient subgroup, different ranking? Which quality indicators do patients find important when choosing a hospital for hip- or knee arthroplasty?

Abstract

BackgroundPatients are increasingly expected to become active, critical consumers in healthcare. They can use comparative healthcare information presented on websites to make informed choices for healthcare providers. However, the use of this information has been limited so far. An obstacle can be that the information is not perceived as relevant by patients. Presenting only the most important quality indicators might improve the usefulness of this information. The aim of this study was to explore which quality indicators different subgroups of patients find important when choosing a hospital for total hip arthroplasty (THA) or total knee arthroplasty (TKA).MethodsIn this explorative, cross-sectional study, questionnaires were distributed to 265 patients who underwent or had to undergo THA/TKA. Participants were asked to rank the importance of three types of quality indicators: patient experience indicators, clinical performance indicators, and indicators about hospital services. We used random effects regression analyses to assess the relative importance of the indicators in different subgroups of patients.Results110 patients (response rate 41.5%) who underwent or had to undergo THA/TKA participated. Conduct of doctors, the presence of procedures to prevent adverse effects of thrombosis and information about the specialist area of orthopaedists were the most important patient experience indicator, clinical performance indicator and indicator about hospital services, respectively. We found a few differences between patient subgroups in the importance attached to the quality indicators.ConclusionsThis study provides a first insight into which quality indicators patients find important when choosing a hospital for THA/TKA, and shows that subgroups of patients differ in the value they attach to these indicators. More extended research is needed to establish the indicators that should at least be presented in succinct overviews of comparative healthcare information for patients choosing a hospital for THA/TKA.

Patients’ Need for Tailored Comparative Health Care Information: A Qualitative Study on Choosing a Hospital

“…The importance of the medical specialist in health care decision making [13,30] and the need for information about specialists’ interpersonal and communication skills and expertise [14] is also revealed in other research. The availability of online doctor-rating websites is growing and these websites have gained popularity among patients internationally [31-34].…”

“…This stresses the importance of making information as easy to understand as possible. It has also been shown that people have different information needs depending on the disease or condition [13,38]. Whether preferences for how information should be presented also differ among diseases is yet unknown.…”

“…First, as part of the larger research project, we posted calls on websites of patient organizations for orthopedic patients and patients with eye disorders, on websites of Dutch associations for senior citizens, and on the website of the NPCF. Respondents to a questionnaire that was part of the research larger project could also enroll themselves in this study by reporting their interest at the end of the questionnaire [13]. Via this route, 56 patients were included.…”

Patients’ expectations of variation in quality of care relates to their search for comparative performance information

“…The factors included the available CPI for hip and knee replacements in the Netherlands, which gave the name of the organisation and the clinical performance of the care providers. Formally, ‘distance’ and ‘reputation’ are not CPI, but they were included because they are important to patients [ 9 , 11 , 28 ]. In this sense, such information can be seen as part of the performance of the healthcare system.…”

“…American and British studies have shown that the actual use of CPI for hospital care is restricted to 4–14% of the consumers [ 5 , 6 ], while the idea of choice appeals to most consumers [ 7 ]. Several Dutch studies of CPI for total hip or knee replacements have been performed [ 8 - 11 ]. The patients in Moser and colleagues’ study considered CPI to be an additional source of information when they were preparing for a doctor’s appointment.…”