Laverty Anthony A, Dixon Anna, Millett Christopher
Department of Primary Care & Public Health, Imperial College London, London, UK.
King's Fund, London, UK.
Health Expect. 2015 Oct;18(5):1127-38. doi: 10.1111/hex.12086. Epub 2013 May 28.
This study examines whether the information used to inform hospital choice, and the sources of that information, varies with patients' socio-demographic characteristics. It also examines whether information used by patients to inform choice is associated with attending their local hospital.
A survey of 1033 patients who were offered a choice of hospital provider for elective treatment in England. Logistic regression was used to examine associations between patient characteristics and information used to inform choice of a hospital provider and sources of information used.
Factors most important to patients in choosing a hospital were quality of care, cleanliness, standard of facilities and reputation. While quality of care and related factors are important to the majority of patients, those with lower levels of education were more likely to report that location and appointment times were important. Those who thought quality important were more likely to attend their local hospital provider. The main sources of information used to inform choice of hospital were own experience, family and friends and the general practitioner (GP). Patients who sought advice from their GP or booking advisors were less likely to attend their local hospitals.
Differences among patients as to what factors are important when choosing a hospital provider and what information and support they access suggest there needs to be a variety of information sources and support available to promote choice. Greater shared decision making through active involvement and support by GPs or booking advisors may be required if they are to make choices in line with their preferences.
本研究探讨用于指导医院选择的信息及其来源是否因患者的社会人口学特征而异。同时研究患者用于指导选择的信息是否与就诊于当地医院有关。
对1033名在英格兰可选择医院进行择期治疗的患者进行调查。采用逻辑回归分析来研究患者特征与用于指导医院选择的信息及信息来源之间的关联。
患者选择医院时最重要的因素是医疗质量、清洁程度、设施标准和声誉。虽然医疗质量及相关因素对大多数患者很重要,但教育程度较低的患者更有可能表示地理位置和预约时间很重要。认为质量重要的患者更有可能就诊于当地医院。用于指导医院选择的主要信息来源是自身经历、家人和朋友以及全科医生(GP)。向全科医生或预约顾问寻求建议的患者就诊于当地医院的可能性较小。
患者在选择医院时认为重要的因素以及他们获取的信息和支持存在差异,这表明需要有多种信息来源和支持以促进选择。如果患者要根据自己的偏好做出选择,可能需要全科医生或预约顾问通过积极参与和支持来进行更多的共同决策。