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

Abstract

BackgroundChoice of hospital based on comparative performance information (CPI) was introduced for Dutch healthcare consumers at least 5 years ago, but CPI use has not yet become commonplace. Our aim was to assess the role of patients’ expectations regarding variation in the quality of hospital care in determining whether they search for CPI.MethodsA questionnaire (for a cross-sectional survey) was distributed to 475 orthopaedic patients in a consecutive sample, who underwent primary hip or knee replacement in a university, teaching, or community hospital between September 2009 and July 2010.ResultsOf the 302 patients (63%) who responded, 13% reported searching for CPI to help them choose a hospital. People who expected quality differences between hospitals (67%) were more likely to search for CPI (OR =3.18 [95% CI: 1.02–9.89]; p <0.04) than those who did not. Quality differences were most often expected in hospital reputation, distance, and accessibility. Patients who did not search for CPI stated that they felt no need for this type of information.ConclusionPatients’ expectations regarding variation in quality of care are positively related to their reported search for CPI. To increase the relevance of CPI for patients, future studies should explore the underlying reasoning of patients about meaningful quality-of-care variation between hospitals.

Factors Influencing the Choice of Hospital after Primary Total Hip and Knee Replacement Surgeries

“…Contrary to the recommendations of Jung et al [24], specialists should be more informed than GPs about patient expectations, include these in their decisions [12], and provide patients with targeted advice on a choice of hospital. In contrast to the results of Ketelaar et al, the distance to the hospital was less important and was in the lower half of the weighted factors, along with the hospital size [11].…”

“…Since it was not a lack of interest nor any lack of understanding that explains why patients make so little use of publicly available qualitative information, but that it was instead an unawareness of its relevance [19], patients should be made more aware of the options for selecting providers based on published quality indicators [11]. These include thorough information about the quality of treatment, which received the highest priority among the respondents and could contribute to improving their levels of future satisfaction [11]. The respondents' second most important criterion was being fully informed about the planned treatment, which can be seen as an incentive to provide even better consulting about the outcomes that can be expected from upcoming operations.…”

“…Various studies have shown that reports published of treatment quality have been considered by patients in their choice, and that higher expectations are associated with better qualitative results [9,10]. Ketelaar et al collected the hospital-related factors behind the selection of hospitals, and found that their reputation and their distance from the patient's home were the most significant ones [11]. Webb and Lloyd concluded that patient expectations can influence physicians in their decisions [12].…”

How Do People Choose to Be Informed? A Survey of The Information Searched for in The Choice of Primary Care Provider in Sweden

“…In studies investigating information seeking behaviour among patients who did seek some sort of information prior to their choice of provider, results demonstrated that most patients relied on dependent information sources such as recommendations from family and friends, information from the referring doctor, or from the chosen provider (16)(17)(18). Signi cantly fewer had searched for "advanced" information from independent and professional information sources, such as comparative information about differences in quality of services disclosed by o cial authorities (19)(20)(21).…”

The Placebo Phenomenon: A Narrow Focus on Psychological Models

“…Although the terms expectancy and expectation have been commonly interchanged, expectation refers to the measurable beliefs and constructs that are consciously verbalized by individuals, including patients and practitioners (Corsi and Colloca 2017), while expectancy has been defined as the subset of psychophysiologically driven predictions that can exist without an individual’s full awareness (Colloca 2017; Laferton et al 2017). …”