H.J. Smeets
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2 records found
1
Choosing between hospitals
The influence of the experiences of other patients
Objective. Publicly available information on hospital performance is increasing, with the aim to support consumers when choosing a hospital. Besides general hospital information and information on outcomes of care, there is increasing availability of systematically collected information on experiences of other patients. The aim of this study was to assess the influence of previous patients' experiences relative to other information when choosing a hospital for surgical treatment. Methods. Three hundred thirty-seven patient volunteers and 280 healthy volunteers (response rate of 52.4% and 93.3%, respectively) filled out an Internet-based questionnaire that included an adaptive choice-based conjoint analysis. They were asked to select hospital characteristics they would use for future hospital choice, compare hospitals, and choose the overall best hospital. Based on the respondents' choices, the relative importance (RI) of each hospital characteristic for each respondent was estimated using hierarchical Bayes estimation. Results. Information based on previous patients' experience was considered at least as important as information provided by hospitals. "Report card regarding physician's expertise" had the highest RI (16.83 [15.37-18.30]) followed by "waiting time for outpatient clinic appointment" (14.88 [13.42-16.34]) and "waiting time for surgery" (7.95 [7.12-8.78]). Patient and healthy volunteers considered the same hospital attributes to be important, except that patient volunteers assigned greater importance to "positive judgment about physician communication" (7.65 v. 5.80, P < 0.05) and lower importance to "complications" (2.56 v. 4.22, P < 0.05). Conclusion. Consumers consider patient experience-based information at least as important as hospital-based information. They rely most on information regarding physicians' expertise, waiting time, and physicians' communication when choosing a hospital.
Objective: To assess whether patients who experience adverse outcomes during hospitalisation or after discharge differ in the information they would use for future choices of a hospital for surgery compared with patients without any adverse outcomes. Design: Cross-sectional questionnaire study, including questions on (1) adverse outcome occurrence during hospitalisation and after discharge, (2) information patients would use for future hospital choice and (3) priority of information. Setting: Three hospitals in the western part of The Netherlands. Study sample All 2122 patients who underwent elective aorta reconstruction (for treatment of aneurysm), cholecystectomy, colon resection, inguinal hernia repair, oesophageal resection or thyroid surgery in the period 2005e2006, of whom 1329 (62.6%) responded. Results: Patients who experienced postdischarge adverse outcomes intend to use more information items to choose a future hospital (on average 1.6 items more). They more often would use the item on information provision during hospitalisation (OR 2.35 (1.37 to 4.03)) and information on various quality-of-care measures, compared with patients without adverse outcomes. Patients who experienced in-hospital adverse outcomes would not use more information items but more often would use the item on mortality after surgery (OR 1.93 (1.27 to 2.94)) and extended hospital stay (OR 1.61 (1.10 to 2.36)). However, when asked for priority of information, previous treatment in that hospital is mentioned as the most important item by most patients (32%), regardless of adverse outcome occurrence, followed by hospital reputation and waiting time. Conclusions: Adverse outcome experience may change the information patients use (on quality of care) to choose a future hospital.