Institute of Health Care Organization Administration, College of Public Health, National Taiwan University, Taipei, Taiwan.
J Eval Clin Pract. 2010 Feb;16(1):14-20. doi: 10.1111/j.1365-2753.2008.01105.x.
Little is known about doctors' preferences regarding public report card design. Taiwan just announced the first diabetes report card on April 2008. The aim of this study was to investigate the Diabetes Mellitus (DM) providers' preferences towards four report card attributes: update frequency, risk adjustment, content information and display format.
A discrete choice questionnaire was mailed to hospital and primary care doctors in the northern part of Taiwan, with 221 study targets. The response rate was 29%.
Using random effect logistic regression, doctors' preference attribute rankings were risk adjustment for patients (44.7%), content information (25.2%), display format (18.3%) and update frequency (11.8%). One-year update frequency, risk adjustment, detailed scores of technical quality and interpersonal quality and bar chart display were the most important items noted in our survey.
This is the first study to investigate provider's preferences for a diabetes report card. It enables the policy maker to clearly see the implication of trade-offs between different choices when designing a report card that doctors will like. Our findings suggest that doctors do not favour the 'less is more' principle, or the higher frequency of updates that patients may prefer. Rather, our findings suggest that risk adjustment and more information content are the most important factors for doctors. Future studies should use discrete choice experiment on different aspects of report card design, such as vulnerable patients or health care administrations.
对于公共报告卡设计,医生的偏好知之甚少。台湾刚刚在 2008 年 4 月公布了第一张糖尿病报告卡。本研究旨在调查糖尿病(DM)提供者对以下四个报告卡属性的偏好:更新频率、风险调整、内容信息和显示格式。
向台湾北部的医院和初级保健医生邮寄了一份离散选择问卷,共有 221 个研究目标。回复率为 29%。
使用随机效应逻辑回归,医生的偏好属性排名为患者风险调整(44.7%)、内容信息(25.2%)、显示格式(18.3%)和更新频率(11.8%)。一年更新频率、风险调整、技术质量和人际质量的详细得分以及条形图显示是我们调查中最关注的项目。
这是第一项调查提供者对糖尿病报告卡偏好的研究。它使决策者清楚地看到在设计医生喜欢的报告卡时,不同选择之间权衡取舍的影响。我们的研究结果表明,医生不赞成“少即是多”的原则,或者患者可能更喜欢的更新频率更高。相反,我们的研究结果表明,风险调整和更多的信息内容是医生最重要的因素。未来的研究应该在报告卡设计的不同方面使用离散选择实验,例如弱势患者或医疗保健管理部门。