title: Ranking sources of hospital quality information for orthopedic surgery patients: consequences for the system of managed competition.
abstract: BACKGROUND
  Healthcare quality information is crucial for the system of managed competition. Within a system of managed competition, health insurers can selectively contract care providers and are allowed to channel patients towards contracted providers. The idea is that insurers have a stronger bargaining position compared to care providers when they are able to channel patients. In the Dutch system of managed competition that was implemented in 2006, channelling patients to preferred providers has not yet been very successful. Empirical knowledge of which sources of hospital quality information they find important may help us to understand how to channel patients to preferred providers.
  
  
  OBJECTIVE
  The objective of this survey was to measure how patients rank various sources of information when they compare hospital quality in a system of managed competition.
  
  
  METHODS
  A written survey was conducted among clients of a large Dutch health insurance company. These clients underwent orthopedic surgery on the hip or knee no longer than 12 months ago.
  
  
  RESULTS
  Two major players within a system of managed competition-health insurers and the government-were not seen as important sources of hospital quality information. In contrast, own experience and general practitioners (GPs) were seen as the most important sources of hospital quality information within the Dutch system of managed competition.
  
  
  CONCLUSIONS
  Health insurers should take the main finding-that GPs are the most important source of hospital quality information-into account when they contract care providers and develop strategies for channeling patients towards preferred providers. A well-functioning system of managed competition will benefit patients, as it involves incentives for care providers to increase healthcare quality and to produce at the lowest cost per unit of quality.
authors.affiliation: Netherlands Institute for Health Services Research, Utrecht, The Netherlands. r.bes@nivel.nl
authors.forename: Romy Evelien
authors.initials: RE
authors.lastname: Bes
authors.forename: Bernard
authors.initials: B
authors.lastname: van den Berg
mesh_terms: D019985:Benchmarking; D054626:Consumer Health Information; D005260:Female; D058006:General Practice; D019538:Health Care Surveys; D006761:Hospitals; D006801:Humans; D033181:Information Dissemination; D008297:Male; D018854:Managed Competition; D008875:Middle Aged; D009426:Netherlands; D019637:Orthopedic Procedures; D057240:Patient Preference; D011787:Quality of Health Care; D012017:Referral and Consultation
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