Emmert Martin, Meszmer Nina, Jablonski Lisa, Zinth Lena, Schöffski Oliver, Taheri-Zadeh Fatemeh
School of Business and Economics, Health Services Management, University of Erlangen-Nuremberg, Lange Gasse 20 90403 Nuremberg, Nuremberg, Germany.
Media, Information and Design Department of Information and Communication, University of Applied Sciences and Arts, Hannover, Germany.
Health Econ Rev. 2017 Sep 26;7(1):33. doi: 10.1186/s13561-017-0171-5.
To evaluate the impact of different dissemination channels on the awareness and usage of hospital performance reports among referring physicians, as well as the usefulness of such reports from the referring physicians' perspective.
DATA SOURCES/STUDY SETTING: Primary data collected from a survey with 277 referring physicians (response rate = 26.2%) in Nuremberg, Germany (03-06/2016).
Cluster-randomised controlled trial at the practice level. Physician practices were randomly assigned to one of two conditions: (1) physicians in the control arm could become aware of the performance reports via mass media channels (Mass Media, [Formula: see text]=132, [Formula: see text]=147); (2) physicians in the intervention arm also received a printed version of the report via mail (Mass and Special Media, [Formula: see text]=117; [Formula: see text]=130).
Overall, 68% of respondents recalled hospital performance reports and 21% used them for referral decisions. Physicians from the Mass and Special Media group were more likely to be aware of the performance reports (OR 4.16; 95% CI 2.16-8.00, p < .001) but not more likely to be influenced when referring patients into hospitals (OR 1.73; 95% CI 0.72-4.12, p > .05). On a 1 (very good) to 6 (insufficient) scale, the usefulness of the performance reports was rated 3.67 (±1.40). Aggregated presentation formats were rated more helpful than detailed hospital quality information.
Hospital quality reports have limited impact on referral practices. To increase the latter, concerns raised by referring physicians must be given more weight. Those principally refer to the underlying data, the design of the reports, and the lack of important information.
评估不同传播渠道对转诊医生对医院绩效报告的知晓度和使用率的影响，以及从转诊医生的角度评估此类报告的有用性。
数据来源/研究背景：从对德国纽伦堡277名转诊医生的调查中收集的原始数据（回复率=26.2%）（2016年3月至6月）。
实践层面的整群随机对照试验。医生诊所被随机分配到两种情况之一：（1）对照组的医生可通过大众媒体渠道知晓绩效报告（大众媒体组，[公式：见正文]=132，[公式：见正文]=147）；（2）干预组的医生还通过邮件收到报告的印刷版（大众媒体与特殊媒体组，[公式：见正文]=117；[公式：见正文]=130）。
总体而言，68%的受访者回忆起医院绩效报告，21%将其用于转诊决策。大众媒体与特殊媒体组的医生更有可能知晓绩效报告（比值比4.16；95%置信区间2.16 - 8.00，p <.001），但在将患者转诊至医院时受影响的可能性并无差异（比值比1.73；95%置信区间0.72 - 4.12，p >.05）。在1（非常好）至6（不足）的评分尺度上，绩效报告的有用性评分为3.67（±1.40）。汇总呈现形式的评分比详细的医院质量信息更有帮助。
医院质量报告对转诊实践的影响有限。为提高其影响，必须更重视转诊医生提出的问题。这些问题主要涉及基础数据、报告设计以及重要信息的缺失。
