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一项横断面研究,评估在线评分与医疗结构及质量指标之间的关联:来自两个德国医生评分网站的结果。

A cross-sectional study assessing the association between online ratings and structural and quality of care measures: results from two German physician rating websites.

作者信息

Emmert Martin, Adelhardt Thomas, Sander Uwe, Wambach Veit, Lindenthal Jörg

机构信息

Friedrich-Alexander-University Erlangen-Nuremberg, School of Business and Economics, Institute of Management (IFM), Lange Gasse 20, 90403, Nuremberg, Germany.

Chair of Health Management, Friedrich-Alexander-University Erlangen-Nuremberg, School of Business and Economics, Institute of Management (IFM), Lange Gasse 20, 90403, Nuremberg, Germany.

出版信息

BMC Health Serv Res. 2015 Sep 24;15:414. doi: 10.1186/s12913-015-1051-5.

Abstract

BACKGROUND

Even though physician rating websites (PRWs) have been gaining in importance in both practice and research, little evidence is available on the association of patients' online ratings with the quality of care of physicians. It thus remains unclear whether patients should rely on these ratings when selecting a physician. The objective of this study was to measure the association between online ratings and structural and quality of care measures for 65 physician practices from the German Integrated Health Care Network "Quality and Efficiency" (QuE).

METHODS

Online reviews from two German PRWs were included which covered a three-year period (2011 to 2013) and included 1179 and 991 ratings, respectively. Information for 65 QuE practices was obtained for the year 2012 and included 21 measures related to structural information (N = 6), process quality (N = 10), intermediate outcomes (N = 2), patient satisfaction (N = 1), and costs (N = 2). The Spearman rank coefficient of correlation was applied to measure the association between ratings and practice-related information.

RESULTS

Patient satisfaction results from offline surveys and the patients per doctor ratio in a practice were shown to be significantly associated with online ratings on both PRWs. For one PRW, additional significant associations could be shown between online ratings and cost-related measures for medication, preventative examinations, and one diabetes type 2-related intermediate outcome measure. There again, results from the second PRW showed significant associations with the age of the physicians and the number of patients per practice, four process-related quality measures for diabetes type 2 and asthma, and one cost-related measure for medication.

CONCLUSIONS

Several significant associations were found which varied between the PRWs. Patients interested in the satisfaction of other patients with a physician might select a physician on the basis of online ratings. Even though our results indicate associations with some diabetes and asthma measures, but not with coronary heart disease measures, there is still insufficient evidence to draw strong conclusions. The limited number of practices in our study may have weakened our findings.

摘要

背景

尽管医师评级网站在实践和研究中都变得越来越重要,但关于患者在线评级与医师医疗质量之间的关联,几乎没有可用的证据。因此,尚不清楚患者在选择医师时是否应该依赖这些评级。本研究的目的是衡量德国综合医疗保健网络“质量与效率”(QuE)中65个医师执业机构的在线评级与医疗结构和质量指标之间的关联。

方法

纳入了来自两个德国医师评级网站的在线评论,这些评论涵盖了三年时间(2011年至2013年),分别包含1179条和991条评级。获取了2012年65个QuE执业机构的信息,包括与结构信息(N = 6)、过程质量(N = 10)、中间结果(N = 2)、患者满意度(N = 1)和成本(N = 2)相关的21项指标。应用斯皮尔曼等级相关系数来衡量评级与执业机构相关信息之间的关联。

结果

线下调查的患者满意度结果以及一个执业机构中每位医生的患者比例与两个医师评级网站上的在线评级均显著相关。对于其中一个医师评级网站,在线评级与药物治疗、预防性检查的成本相关指标以及一项2型糖尿病相关的中间结果指标之间还存在其他显著关联。同样,第二个医师评级网站的结果显示,在线评级与医师年龄、每个执业机构的患者数量、2型糖尿病和哮喘的四项过程相关质量指标以及一项药物治疗成本相关指标之间存在显著关联。

结论

发现了几个显著关联,这些关联在不同的医师评级网站之间有所不同。对其他患者对医师满意度感兴趣的患者可能会根据在线评级来选择医师。尽管我们的结果表明与一些糖尿病和哮喘指标存在关联,但与冠心病指标无关,但仍然没有足够的证据得出强有力的结论。我们研究中执业机构数量有限可能削弱了我们的研究结果。

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