title: Patients' expectations of variation in quality of care relates to their search for comparative performance information.
abstract: BACKGROUND
  Choice of hospital based on comparative performance information (CPI) was introduced for Dutch healthcare consumers at least 5 years ago, but CPI use has not yet become commonplace. Our aim was to assess the role of patients' expectations regarding variation in the quality of hospital care in determining whether they search for CPI.
  
  
  METHODS
  A questionnaire (for a cross-sectional survey) was distributed to 475 orthopaedic patients in a consecutive sample, who underwent primary hip or knee replacement in a university, teaching, or community hospital between September 2009 and July 2010.
  
  
  RESULTS
  Of the 302 patients (63%) who responded, 13% reported searching for CPI to help them choose a hospital. People who expected quality differences between hospitals (67%) were more likely to search for CPI (OR =3.18 [95% CI: 1.02-9.89]; p <0.04) than those who did not. Quality differences were most often expected in hospital reputation, distance, and accessibility. Patients who did not search for CPI stated that they felt no need for this type of information.
  
  
  CONCLUSIONS
  Patients' expectations regarding variation in quality of care are positively related to their reported search for CPI. To increase the relevance of CPI for patients, future studies should explore the underlying reasoning of patients about meaningful quality-of-care variation between hospitals.
authors.affiliation: Scientific Institute for Quality of Healthcare (114), Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands. Nicole.Ketelaar@gmail.com.
authors.forename: Nicole A B M
authors.initials: NA
authors.lastname: Ketelaar
authors.affiliation: Scientific Institute for Quality of Healthcare (114), Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands. Marjan.Faber@radboudumc.nl.
authors.forename: Marjan J
authors.initials: MJ
authors.lastname: Faber
authors.affiliation: Scientific Institute for Quality of Healthcare (114), Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands. Joze.Braspenning@radboudumc.nl.
authors.forename: Jozé C
authors.initials: JC
authors.lastname: Braspenning
authors.affiliation: Scientific Institute for Quality of Healthcare (114), Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands. Gert.Westert@radboudumc.nl.
authors.forename: Gert P
authors.initials: GP
authors.lastname: Westert
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires