title: Is the impact of hospital performance data greater in patients who have compared hospitals?
abstract: BACKGROUND
  Public information on average has limited impact on patients' hospital choice. However, the impact may be greater in consumers who have compared hospitals prior to their hospital choice. We therefore assessed whether patients who have compared hospitals based their hospital choice mainly on public information, rather than e.g. advice of their general practitioner and consider other information important than patients who have not compared hospitals.
  
  
  METHODS
  337 new surgical patients completed an internet-based questionnaire. They were asked whether they had compared hospitals prior to their hospital choice and which factors influenced their choice. They were also asked to select between four and ten items of hospital information (total: 41 items) relevant for their future hospital choice. These were subsequently used in a hospital choice experiment in which participants were asked to compare hospitals in an Adaptive Choice-Based Conjoint analysis to estimate which of the hospital characteristics had the highest Relative Importance (RI).
  
  
  RESULTS
  Patients who have compared hospitals more often used public information for their hospital choice than patients who have not compared hospitals (12.7% vs. 1.5%, p < 0.001). However, they still mostly relied on their own (47.9%) and other people's experiences (31%) rather than to base their decision on public information. Both groups valued physician's expertise (RI 20.2 [16.6-24.8] in patients comparing hospitals vs. 16.5 [14.2-18.8] in patients not comparing hospitals) and waiting time (RI 15.1 [10.7-19.6] vs. 15.6 [13.2-17.9] respectively) as most important public information. Patients who have compared hospitals assigned greater importance to information on wound infections (p = 0.010) and respect for patients (p = 0.022), but lower importance to hospital distance (p = 0.041).
  
  
  CONCLUSIONS
  Public information has limited impact on patient's hospital choice, even in patients who have actually compared hospitals prior to hospital choice.
authors: Department of Medical Decision Making, Leiden University Medical Center, The Netherlands.
authors: Ingrid B
authors: IB
authors: de Groot
authors: Wilma
authors: W
authors: Otten
authors: Harm J
authors: HJ
authors: Smeets
authors: Perla J
authors: PJ
authors: Marang-van de Mheen
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008490:Medical Informatics / Q000379:methods*; D008875:Middle Aged; D009426:Netherlands; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data; D057240:Patient Preference; D011639:Public Opinion; D011785:Quality Assurance, Health Care; D013514:Surgical Procedures, Operative / Q000592:standards* / Q000639:trends; D011795:Surveys and Questionnaires