title: The use of publicly available quality information when choosing a hospital or health-care provider: the role of the GP.
abstract: BACKGROUND
  Patients barely use publicly available quality information for making a decision concerning secondary health care, but instead rely on information coming from their general practitioner (GP). An intermediate role of GPs has been suggested concerning the use of publicly available quality information. The aim of the study is to quantify and explore GPs' use of publicly available quality information when referring patients or suggesting secondary health-care provider to them.
  
  
  METHODS
  In this cross-sectional study, an invitation to an electronic questionnaire was sent to 858 GPs in the south of the Netherlands. GPs were asked about their use of and perception towards publicly available quality information through closed-ended and open-ended questions. Differences among subgroups were tested for significance using Pearson's chi-square tests.
  
  
  RESULTS
  The majority of respondents (89.5%) never or rarely use publicly available quality information. They perceive them as invalid and unreliable. Distance to the hospital, prior experiences and personal contacts with specialists guide them when advising and referring. Almost 90% of respondents never or rarely suggest quality information as support for decision making to their patients. No significant differences between subgroups were observed.
  
  
  CONCLUSIONS
  This study is among the firsts exploring and quantifying GPs' use of publicly available quality information. The results suggest that publicly available quality information appears in its current format and application not useful for GPs. GPs have to be aware of their influential role in patients' decision making and possibly have to take more responsibility in guiding them through the jungle of quality information.
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (Caphri) of the Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Nora
authors.initials: N
authors.lastname: Doering
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Maarse
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D058005:General Practitioners; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D012017:Referral and Consultation
keywords: Decision making; patient-doctor communication; quality information