The importance of experienced adverse outcomes on patients' future choice of a hospital for surgery.
OBJECTIVE
To assess whether patients who experience adverse outcomes during hospitalisation or after discharge differ in the information they would use for future choices of a hospital for surgery compared with patients without any adverse outcomes.


METHODS
Cross-sectional questionnaire study, including questions on (1) adverse outcome occurrence during hospitalisation and after discharge, (2) information patients would use for future hospital choice and (3) priority of information.


METHODS
Three hospitals in the western part of The Netherlands.


METHODS
All 2122 patients who underwent elective aorta reconstruction (for treatment of aneurysm), cholecystectomy, colon resection, inguinal hernia repair, oesophageal resection or thyroid surgery in the period 2005-2006, of whom 1329 (62.6%) responded.


RESULTS
Patients who experienced postdischarge adverse outcomes intend to use more information items to choose a future hospital (on average 1.6 items more). They more often would use the item on information provision during hospitalisation (OR 2.35 (1.37 to 4.03)) and information on various quality-of-care measures, compared with patients without adverse outcomes. Patients who experienced in-hospital adverse outcomes would not use more information items but more often would use the item on mortality after surgery (OR 1.93 (1.27 to 2.94)) and extended hospital stay (OR 1.61 (1.10 to 2.36)). However, when asked for priority of information, previous treatment in that hospital is mentioned as the most important item by most patients (32%), regardless of adverse outcome occurrence, followed by hospital reputation and waiting time.


CONCLUSIONS
Adverse outcome experience may change the information patients use (on quality of care) to choose a future hospital.
Department of Medical Decision Making, Leiden University Medical Center, J10-S, PO Box 9600, Leiden 2300 RC, The Netherlands. p.j.marang@lumc.nl
P J
PJ
Marang-van de Mheen
J
J
Dijs-Elsinga
W
W
Otten
M
M
Versluijs
H J
HJ
Smeets
W J
WJ
van der Made
R
R
Vree
J
J
Kievit
D000368:Aged; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006761:Hospitals; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D057240:Patient Preference