NIVEL (Netherlands Institute for Health Services Research), Research Program Patient Perspective and Demand-Driven Health Care, Utrecht, the Netherlands (OCD, PS, JR, MH)
VU University Medical Center, Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, Amsterdam, the Netherlands (OCD)
Med Decis Making. 2012 Mar-Apr;32(2):287-300. doi: 10.1177/0272989X11415115. Epub 2011 Aug 15.
The recent emphasis on providing comparative health care data to the public has resulted in a large amount of online information. To focus on the most essential attributes, insight is needed into which attributes are actually considered by consumers.
To assess which attributes of Dutch hospital performance information contribute most to consumers' hospital choice for cataract and total hip or knee replacement surgery.
Two discrete-choice experiments were performed: one for cataract surgery and one for total hip or knee replacement surgery. Participants viewed hypothetical hospitals based on representative values for 10 attributes (e.g., distance to the hospital, waiting time for the surgery, conduct of professionals, information provision, complication rate) and were asked to select the hospital they would choose if they needed treatment. We used multilevel logistic regression analysis to test the effects of the attributes and the interactions between attributes and respondent characteristics on consumers' hospital choice.
All except one attribute (length of the first appointment with the ophthalmologist) contributed significantly to consumers' choices. Although some differences were found between cataract and hip/knee replacement surgery, the most influential attributes for both types of surgeries were distance, waiting time, and the attributes of patient safety (complication rate of capsular rupture and the use of procedures to prevent adverse effects of thrombosis). Interaction effects were found between hospital attributes, on one hand, and age, education, and consumer choice orientation, on the other hand.
As for cataract and total hip/knee replacement surgery, the attributes that seem most important to consumers when choosing a hospital are access (waiting time and distance) and patient safety attributes.
最近强调向公众提供比较医疗保健数据，导致了大量的在线信息。为了关注最重要的属性，需要深入了解消费者实际上考虑哪些属性。
评估荷兰医院绩效信息的哪些属性对白内障和全髋关节或膝关节置换手术的消费者选择医院的影响最大。
进行了两项离散选择实验：一项用于白内障手术，另一项用于全髋关节或膝关节置换手术。参与者根据 10 个属性的代表性值（例如，到医院的距离、手术等待时间、专业人员的行为、信息提供、并发症发生率）查看假设的医院，并被要求选择如果需要治疗，他们会选择哪家医院。我们使用多水平逻辑回归分析来测试属性的影响以及属性与受访者特征之间的相互作用对消费者医院选择的影响。
除了一个属性（第一次与眼科医生预约的时间长度）外，所有属性都对消费者的选择有显著影响。尽管在白内障和髋关节/膝关节置换手术之间发现了一些差异，但对这两种手术最有影响的属性是距离、等待时间和患者安全属性（囊膜破裂的并发症发生率和使用预防血栓副作用的程序）。还发现了医院属性与年龄、教育程度和消费者选择取向之间的交互作用。
对于白内障和全髋关节/膝关节置换手术，消费者在选择医院时最重要的属性似乎是可及性（等待时间和距离）和患者安全属性。
