Ketelaar Nicole A B M, Faber Marjan J, Braspenning Jozé C, Westert Gert P
Scientific Institute for Quality of Healthcare (114), Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.
BMC Health Serv Res. 2014 Dec 3;14:617. doi: 10.1186/s12913-014-0617-y.
Choice of hospital based on comparative performance information (CPI) was introduced for Dutch healthcare consumers at least 5 years ago, but CPI use has not yet become commonplace. Our aim was to assess the role of patients' expectations regarding variation in the quality of hospital care in determining whether they search for CPI.
A questionnaire (for a cross-sectional survey) was distributed to 475 orthopaedic patients in a consecutive sample, who underwent primary hip or knee replacement in a university, teaching, or community hospital between September 2009 and July 2010.
Of the 302 patients (63%) who responded, 13% reported searching for CPI to help them choose a hospital. People who expected quality differences between hospitals (67%) were more likely to search for CPI (OR =3.18 [95% CI: 1.02-9.89]; p <0.04) than those who did not. Quality differences were most often expected in hospital reputation, distance, and accessibility. Patients who did not search for CPI stated that they felt no need for this type of information.
Patients' expectations regarding variation in quality of care are positively related to their reported search for CPI. To increase the relevance of CPI for patients, future studies should explore the underlying reasoning of patients about meaningful quality-of-care variation between hospitals.
至少在5年前，荷兰医疗保健消费者就开始根据比较绩效信息（CPI）来选择医院，但CPI的使用尚未普及。我们的目的是评估患者对医院护理质量差异的期望在决定他们是否搜索CPI方面所起的作用。
向475名连续抽样的骨科患者发放问卷（用于横断面调查），这些患者于2009年9月至2010年7月期间在大学医院、教学医院或社区医院接受了初次髋关节或膝关节置换手术。
在302名做出回应的患者（63%）中，13%的人报告称搜索过CPI以帮助他们选择医院。预期医院之间存在质量差异的患者（67%）比那些没有这种预期的患者更有可能搜索CPI（比值比=3.18[95%置信区间：1.02 - 9.89]；p<0.04）。质量差异最常体现在医院声誉、距离和可达性方面。未搜索CPI的患者表示他们觉得不需要这类信息。
患者对护理质量差异的期望与他们报告的搜索CPI行为呈正相关。为了提高CPI对患者的相关性，未来的研究应该探索患者对医院之间有意义的护理质量差异的潜在推理。
