Ziemba Justin B, Arenberg Steven, Reustle Holly, Allaf Mohamad E, Haldeman Dalal
J Healthc Qual. 2019 Jul/Aug;41(4):251-258. doi: 10.1097/JHQ.0000000000000167.
Why consumers consistently rank hospital reputation as one of the most important factors when selecting health care services remains unknown. We hypothesized that this is explained by consumers associating reputation with objective quality. We performed a cross-sectional, US population-based survey of consumers (N = 23,410) exploring this association. A Spearman rank order correlation was used to measure the strength of this relationship. Subgroups of consumers more likely to associate the two was explored with multivariable logistic regression. Consumers commonly agree (56%) that a hospital's reputation is the same as its quality of health care. Consumers also associate hospital reputation with the belief that they will be less like to suffer a complication (ρ = 0.509) or die (ρ = 0.441), although the strength of these relationships were modest (all p < 0.01). Consumers who were male (OR: 0.84), Hispanic (OR: 0.82), African American (OR: 0.86), married (OR: 0.85), self-reported as healthy (OR: 0.67), and had a recent hospitalization (OR: 0.70) were less likely to believe that reputation and quality were equivalent (all p < 0.01). This data suggests that consumers link the construct of hospital reputation with objective health care quality, but this pattern of behavior is of concern, particularly when reputation does not align with objective data.
消费者在选择医疗服务时为何一直将医院声誉列为最重要的因素之一,目前尚不清楚。我们假设,这是因为消费者将声誉与客观质量联系在一起。我们对美国消费者(N = 23410)进行了一项基于人群的横断面调查,以探究这种关联。使用斯皮尔曼等级相关来衡量这种关系的强度。通过多变量逻辑回归探究更有可能将两者联系起来的消费者亚组。消费者普遍认同(56%)医院的声誉与其医疗质量相同。消费者还将医院声誉与他们不太可能出现并发症(ρ = 0.509)或死亡(ρ = 0.441)的信念联系起来,尽管这些关系的强度不大(所有p < 0.01)。男性(OR:0.84)、西班牙裔(OR:0.82)、非裔美国人(OR:0.86)、已婚(OR:0.85)、自我报告健康(OR:0.67)以及近期有过住院经历(OR:0.70)的消费者不太可能认为声誉和质量是等同的(所有p < 0.01)。这些数据表明,消费者将医院声誉的概念与客观医疗质量联系起来,但这种行为模式令人担忧,尤其是当声誉与客观数据不一致时。