Creating compact comparative health care information: what are the key quality attributes to present for cataract and total hip or knee replacement surgery?

BACKGROUND

The recent emphasis on providing comparative health care data to the public has resulted in a large amount of online information. To focus on the most essential attributes, insight is needed into which attributes are actually considered by consumers.

OBJECTIVE

To assess which attributes of Dutch hospital performance information contribute most to consumers' hospital choice for cataract and total hip or knee replacement surgery.

DESIGN

Two discrete-choice experiments were performed: one for cataract surgery and one for total hip or knee replacement surgery. Participants viewed hypothetical hospitals based on representative values for 10 attributes (e.g., distance to the hospital, waiting time for the surgery, conduct of professionals, information provision, complication rate) and were asked to select the hospital they would choose if they needed treatment. We used multilevel logistic regression analysis to test the effects of the attributes and the interactions between attributes and respondent characteristics on consumers' hospital choice.

RESULTS

All except one attribute (length of the first appointment with the ophthalmologist) contributed significantly to consumers' choices. Although some differences were found between cataract and hip/knee replacement surgery, the most influential attributes for both types of surgeries were distance, waiting time, and the attributes of patient safety (complication rate of capsular rupture and the use of procedures to prevent adverse effects of thrombosis). Interaction effects were found between hospital attributes, on one hand, and age, education, and consumer choice orientation, on the other hand.

CONCLUSIONS

As for cataract and total hip/knee replacement surgery, the attributes that seem most important to consumers when choosing a hospital are access (waiting time and distance) and patient safety attributes.