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患者价值体系与在线可获取的医师和实践特征之间的关联。

Association Between Patient Value Systems and Physician and Practice Attributes Available Online.

机构信息

Department of Otolaryngology, Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Facial Plastic Surgery Center, Baltimore, Maryland.

出版信息

JAMA Facial Plast Surg. 2018 Mar 1;20(2):116-121. doi: 10.1001/jamafacial.2017.1146.

Abstract

IMPORTANCE

The relative value of facial plastic surgeon personal and practice attributes is relevant to the broader health care system because of increasing out-of-pocket expenses to patients.

OBJECTIVE

To determine the relative value of specific facial plastic surgeon personal and practice attributes available online from the perspective of patients.

DESIGN, SETTING, AND PARTICIPANTS: This study consisted of an electronic survey sent to patients by email using choice-based conjoint analysis; surveys were sent between December 2015 and March 2016. Participants had agreed to join email registries to be sent email surveys and promotions at 3 private facial plastic and reconstructive surgery practices. The following surgeon personal and practice attributes and levels were compared: (1) outcome transparency (above average, average, not available); (2) surgical training affiliations (US News and World Reports rankings); (3) online rating site scores (2 [poor], 3, or 4 [excellent] stars); and (4) price ($1×, $2×, and $3× [× = $1500; average cost was set at $2×]).

MAIN OUTCOMES AND MEASURES

The relative importance of outcome transparency, surgical training affiliations, online rating scores, and price to prospective patients.

RESULTS

Overall, 291 patients participated for a completion rate of 68%. Outcome transparency was the most valued attribute (attribute utility range = 141; attribute importance = 35.2%). Price was the least valued attribute (attribute utility range = 58.59; attribute importance = 15.1%). Assuming top-tier affiliations and 4-star ratings, share of market (SOM) was 75.5% for surgeons with above-average outcome transparency priced at $3× compared with those surgeons with no outcomes available priced at $1×. Holding price constant at $2×, surgeons with middle-tier affiliations and 2-star online ratings but above average outcomes achieved 48.4% SOM when compared with those surgeons with top-tier affiliations and 4-star online ratings without available outcomes.

CONCLUSIONS AND RELEVANCE

Facial plastic surgery patients most value surgeons who publish outcomes. Moreover, they are willing to discount poor rating scores and lower-ranked institutional affiliations when outcome transparency is high. This study demonstrates that outcome transparency is crucial in facial plastic surgery markets.

LEVEL OF EVIDENCE

NA.

摘要

重要性

由于患者自付费用的增加,面部整形外科医生的个人和执业属性的相对价值与更广泛的医疗保健系统有关。

目的

从患者的角度确定在线提供的特定面部整形外科医生个人和执业属性的相对价值。

设计、环境和参与者:本研究包括一项使用基于选择的联合分析通过电子邮件向患者发送的电子调查;调查于 2015 年 12 月至 2016 年 3 月之间进行。参与者同意加入电子邮件注册,以便在 3 家私人面部整形和重建外科手术实践中接收电子邮件调查和促销。比较了以下外科医生的个人和执业属性和级别:(1)结果透明度(高于平均水平、平均水平、不可用);(2)手术培训隶属关系(《美国新闻与世界报道》排名);(3)在线评分网站评分(2[差]、3 或 4[优秀]星);和(4)价格($1×、$2×和$3×[×=1500 美元;平均成本设定为$2×)。

主要结果和测量方法

潜在患者对结果透明度、手术培训隶属关系、在线评分和价格的相对重要性。

结果

总体而言,共有 291 名患者参与,完成率为 68%。结果透明度是最有价值的属性(属性效用范围=141;属性重要性=35.2%)。价格是最没有价值的属性(属性效用范围=58.59;属性重要性=15.1%)。假设顶级隶属关系和 4 星级评级,与没有结果的定价为$1×的结果平均透明度的$3×相比,定价为$3×的结果透明度高于平均水平的外科医生的市场份额(SOM)为 75.5%。保持价格不变在$2×,具有中等隶属关系和 2 星级在线评分但高于平均水平的结果的外科医生的 SOM 达到 48.4%,而具有顶级隶属关系和 4 星级在线评分但没有可用结果的外科医生则为 48.4%。

结论和相关性

面部整形手术患者最看重公布结果的外科医生。此外,当结果透明度高时,他们愿意对评分不佳和隶属关系较低的机构进行折扣。本研究表明,结果透明度在面部整形手术市场中至关重要。

证据水平

无。

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