Emmert Martin, Meier Florian, Pisch Frank, Sander Uwe
Institute of Management-IFM, School of Business and Economics, Friedrich-Alexander-University Erlangen-Nuremberg, Nuremberg, Germany.
J Med Internet Res. 2013 Aug 28;15(8):e187. doi: 10.2196/jmir.2702.
Over the past decade, physician-rating websites have been gaining attention in scientific literature and in the media. However, little knowledge is available about the awareness and the impact of using such sites on health care professionals. It also remains unclear what key predictors are associated with the knowledge and the use of physician-rating websites.
To estimate the current level of awareness and use of physician-rating websites in Germany and to determine their impact on physician choice making and the key predictors which are associated with the knowledge and the use of physician-rating websites.
This study was designed as a cross-sectional survey. An online panel was consulted in January 2013. A questionnaire was developed containing 28 questions; a pretest was carried out to assess the comprehension of the questionnaire. Several sociodemographic (eg, age, gender, health insurance status, Internet use) and 2 health-related independent variables (ie, health status and health care utilization) were included. Data were analyzed using descriptive statistics, chi-square tests, and t tests. Binary multivariate logistic regression models were performed for elaborating the characteristics of physician-rating website users. Results from the logistic regression are presented for both the observed and weighted sample.
In total, 1505 respondents (mean age 43.73 years, SD 14.39; 857/1505, 57.25% female) completed our survey. Of all respondents, 32.09% (483/1505) heard of physician-rating websites and 25.32% (381/1505) already had used a website when searching for a physician. Furthermore, 11.03% (166/1505) had already posted a rating on a physician-rating website. Approximately 65.35% (249/381) consulted a particular physician based on the ratings shown on the websites; in contrast, 52.23% (199/381) had not consulted a particular physician because of the publicly reported ratings. Significantly higher likelihoods for being aware of the websites could be demonstrated for female participants (P<.001), those who were widowed (P=.01), covered by statutory health insurance (P=.02), and with higher health care utilization (P<.001). Health care utilization was significantly associated with all dependent variables in our multivariate logistic regression models (P<.001). Furthermore, significantly higher scores could be shown for health insurance status in the unweighted and Internet use in the weighted models.
Neither health policy makers nor physicians should underestimate the influence of physician-rating websites. They already play an important role in providing information to help patients decide on an appropriate physician. Assuming there will be a rising level of public awareness, the influence of their use will increase well into the future. Future studies should assess the impact of physician-rating websites under experimental conditions and investigate whether physician-rating websites have the potential to reflect the quality of care offered by health care providers.
在过去十年中，医生评分网站在科学文献和媒体中受到了关注。然而，对于医疗保健专业人员对这类网站的认知及其影响了解甚少。与医生评分网站的认知和使用相关的关键预测因素也尚不明确。
评估德国医生评分网站的当前认知水平和使用情况，并确定其对医生选择的影响以及与医生评分网站的认知和使用相关的关键预测因素。
本研究设计为横断面调查。2013年1月咨询了一个在线样本库。编制了一份包含28个问题的问卷；进行了预测试以评估问卷的理解情况。纳入了几个社会人口学变量（如年龄、性别、健康保险状况、互联网使用情况）和2个与健康相关的独立变量（即健康状况和医疗保健利用情况）。使用描述性统计、卡方检验和t检验对数据进行分析。进行二元多变量逻辑回归模型以阐述医生评分网站用户的特征。逻辑回归的结果以观察样本和加权样本呈现。
共有1505名受访者（平均年龄43.73岁，标准差14.39；857/1505，57.25%为女性）完成了我们的调查。在所有受访者中，32.09%（483/1505）听说过医生评分网站，25.32%（381/1505）在寻找医生时已经使用过此类网站。此外，11.03%（166/1505）已经在医生评分网站上发布过评分。约65.35%（249/381）根据网站上显示的评分咨询过特定医生；相比之下，52.23%（199/381）因公开报告的评分而未咨询过特定医生。女性参与者（P<0.001）、丧偶者（P=0.01）、参加法定健康保险者（P=0.02）以及医疗保健利用率较高者（P<0.001）知晓此类网站的可能性显著更高。在我们的多变量逻辑回归模型中，医疗保健利用率与所有因变量均显著相关（P<0.001）。此外，在未加权模型中健康保险状况得分显著更高，在加权模型中互联网使用得分显著更高。
卫生政策制定者和医生都不应低估医生评分网站的影响。它们在为患者提供信息以帮助其选择合适医生方面已经发挥了重要作用。假设公众意识将不断提高，其使用的影响在未来还会进一步增加。未来的研究应在实验条件下评估医生评分网站的影响，并调查医生评分网站是否有潜力反映医疗保健提供者提供的护理质量。
