title: Patient's decision making in selecting a hospital for elective orthopaedic surgery.
abstract: OBJECTIVE
  The admission to a hospital for elective surgery, like arthroplasty, can be planned ahead. The elective nature of arthroplasty and the increasing stimulus of the public to critically select a hospital raise the issue of how patients actually take such decisions. The aim of this paper is to describe the decision-making process of selecting a hospital as experienced by people who underwent elective joint arthroplasty and to understand what factors influenced the decision-making process.
  
  
  METHODS
  Qualitative descriptive study with 18 participants who had a hip or knee replacement within the last 5 years. Data were gathered from eight individual interviews and four focus group interviews and analysed by content analysis.
  
  
  RESULTS
  Three categories that influenced the selection of a hospital were revealed: information sources, criteria in decision making and decision-making styles within the GP- patient relationship. Various contextual aspects influenced the decision-making process. Most participants gave higher priority to the selection of a medical specialist than to the selection of a hospital.
  
  
  CONCLUSIONS
  Selecting a hospital for arthroplasty is extremely complex. The decision-making process is a highly individualized process because patients have to consider and assimilate a diversity of aspects, which are relevant to their specific situation. Our findings support the model of shared decision making, which indicates that general practitioners should be attuned to the distinct needs of each patient at various moments during the decision making, taking into account personal, medical and contextual factors.
authors: Department of General Practice, Maastricht University, Maastricht, The Netherlands. albine.moser@hag.unimaas.nl
authors: Albine
authors: A
authors: Moser
authors: Irene
authors: I
authors: Korstjens
authors: Trudy
authors: T
authors: van der Weijden
authors: Huibert
authors: H
authors: Tange
mesh_terms: D000368:Aged; D002755:Choice Behavior; D017558:Elective Surgical Procedures; D005260:Female; D017144:Focus Groups; D006761:Hospitals; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009985:Orthopedics; D057240:Patient Preference; D010361:Patients / Q000523:psychology*