Sasaki Noriko, Groenewoud Stef, Kunisawa Susumu, Westert Gert, Imanaka Yuichi
Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.
Medicine (Baltimore). 2019 Oct;98(43):e17690. doi: 10.1097/MD.0000000000017690.
The accumulated healthcare performance data related to unwarranted practice variations are not necessarily disseminated to patients and citizens. To clarify the needs for public disclosure, we explored Japanese and Dutch citizens' preferences and values towards information disclosure and healthcare disparity.Online opt-in survey was conducted and we asked citizens their preference to know about the healthcare performance indicators of regions and hospitals, and their attitudes towards healthcare equity. After a descriptive statistical analysis, Chi-squared automatic interaction detection tree analysis was performed to explore the socio-demographic determinants which were associated with positive value for information disclosure and healthcare equity. Then, we compared the combination of attributes of the highest and the lowest subgroups of each country and compared within and between countries. Last, logistic regression analysis was performed to further evaluate the impact of each determinant.Significant differences were observed between the 2 countries (Japan [JPN] 1038; Netherlands [NL] 1040). The crucial attributes identified were age, sex, educational background, and living area (JPN), along with age and sex (NL). Japanese comprised multiple subgroups with heterogeneous values, showed relatively low interest in knowing the information, and seemed to accept healthcare inequality, especially among urban males aged 20 to 59 years. Contrarily, Dutch people mostly showed high interest in both items. Female and older respondents valued information disclosure highly across countries.To share healthcare performance knowledge and empowering the public, historical, cultural, and socio-demographic context including health literacy of citizens' subgroups should be considered in making comprehensive public reports.
与不必要的医疗实践差异相关的累积医疗绩效数据不一定会传播给患者和公民。为了明确公开披露的必要性，我们探讨了日本和荷兰公民对信息披露和医疗差距的偏好及价值观。我们开展了在线选择加入式调查，询问公民对了解地区和医院医疗绩效指标的偏好，以及他们对医疗公平的态度。在进行描述性统计分析后，进行了卡方自动交互检测树分析，以探索与信息披露和医疗公平的积极价值相关的社会人口学决定因素。然后，我们比较了每个国家最高和最低子群体的属性组合，并在国家内部和国家之间进行了比较。最后，进行逻辑回归分析以进一步评估每个决定因素的影响。
在这两个国家（日本[JPN]1038人；荷兰[NL]1040人）之间观察到了显著差异。确定的关键属性包括年龄、性别、教育背景和居住地区（日本），以及年龄和性别（荷兰）。日本包括多个价值观各异的子群体，对了解这些信息的兴趣相对较低，似乎接受医疗不平等，尤其是在20至59岁的城市男性中。相反，荷兰人大多对这两项都表现出很高的兴趣。在各个国家中，女性和年长的受访者都非常重视信息披露。
为了分享医疗绩效知识并增强公众权能，在制作全面的公共报告时，应考虑包括公民子群体的健康素养在内的历史、文化和社会人口学背景。
