Abstract
Background:Patient utilization of public reporting has been suboptimal despite attempts to encourage use. Lack of utilization may be due to discordance between reported metrics and what patients want to know when making health care choices.Objective:The objective of this study was to identify measures of quality that individuals want to be presented in public reporting and explore factors associated with researching health care.Research Design:Patient interviews and focus groups were conducted to develop a survey exploring the relative importance of various health care measures.Subjects:Interviews and focus groups conducted at local outpatient clinics. A survey administered nationally on an anonymous digital platform.Measures:Likert scale responses were compared using tests of central tendency. Rank-order responses were compared using analysis of variance testing. Associations with binary outcomes were analyzed using multivariable logistic regression.Results:Overall, 4672 responses were received (42.0% response rate). Census balancing yielded 2004 surveys for analysis. Measures identified as most important were hospital reputation (considered important by 61.9%), physician experience (51.5%), and primary care recommendations (43.2%). Unimportant factors included guideline adherence (17.6%) and hospital academic affiliation (13.3%, P<0.001 for all compared with most important factors). Morbidity and mortality outcome measures were not among the most important factors. Patients were unlikely to rank outcome measures as the most important factors in choosing health care providers, irrespective of age, sex, educational status, or income.Conclusions:Patients valued hospital reputation, physician experience, and primary care recommendations while publicly reported metrics like patient outcomes were less important. Public quality reports contain information that patients perceive to be of relatively low value, which may contribute to low utilization.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 867-873 |
| Number of pages | 7 |
| Journal | Medical care |
| Volume | 58 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2020 |
Funding
R.J.E., T.K.Y., and D.B.H. were supported by a postdoctoral research fel-lowship [Agency for Healthcare Research and Quality (AHRQ) 5T32HS000078]. R.P.M. is supported by the Agency for Healthcare Quality (K12HS026385) and an Institutional Research Grant from the American Cancer Society (IRG-18-163-24). The remaining authors declare no conflict of interest. Supported by the Agency for Healthcare Research and Quality grant (R21HS021857; PI: K.Y.B.) entitled “Engaging Patients and Hospitals to Expand Public Reporting in Surgery.” The American College of Surgeons as an organization had no role in the design and conduct of the study; analysis and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Views expressed in this work represent those of the authors only.
Keywords
- healthcare quality
- patient centered care
- patient preferences
- public reporting
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
