Uwe Sander

Purpose: This study aims to determine the intention to use hospital report cards (HRCs) for hospital referral purposes in the presence or absence of patient-reported outcomes (PROs) as well as to explore the relevance of publicly available hospital performance information from the perspective of referring physicians. Methods: We identified the most relevant information for hospital referral purposes based on a literature review and qualitative research. Primary survey data were collected (May–June 2021) on a sample of 591 referring orthopedists in Germany and analyzed using structural equation modeling. Participating orthopedists were recruited using a sequential mixed-mode strategy and randomly allocated to work with HRCs in the presence (intervention) or absence (control) of PROs. Results: Overall, 420 orthopedists (mean age 53.48, SD 8.04) were included in the analysis. The presence of PROs on HRCs was not associated with an increased intention to use HRCs (p = 0.316). Performance expectancy was shown to be the most important determinant for using HRCs (path coefficient: 0.387, p < .001). However, referring physicians have doubts as to whether HRCs can help them. We identified “complication rate” and “the number of cases treated” as most important for the hospital referral decision making; PROs were rated slightly less important. Conclusions: This study underpins the purpose of HRCs, namely to support referring physicians in searching for a hospital. Nevertheless, only a minority would support the use of HRCs for the next hospital search in its current form. We showed that presenting relevant information on HRCs did not increase their use intention.

Einleitung Patienten äußern sich in den sozialen Medien, um ihre Zufriedenheit und Erfahrungen anderen Internetnutzern mitzuteilen. Die öffentlichen Erfahrungen mit dem Gesundheitssystem können von anderen Patienten für die Wahl von Leistungsanbietern genutzt werden. Über Reha-Kliniken liegen bisher keine Erkenntnisse zu Online-Bewertungen vor. Es ist nicht bekannt, wie die Bewertungen ausfallen und anhand welcher Kriterien diese erfolgen. Diese Forschungslücke sollte mit der von der DRV Bund geförderten ZURESO-Studie geschlossen werden (02/2018-10/2019). Methoden Datenbasis bildeten die auf Klinikbewertungen.de (N = 24.806; 483 Kliniken) und Facebook (N = 4.127; 192 Kliniken) verfügbaren Bewertungen zu Reha-Kliniken der Rentenversicherung im Zeitraum 10/2014 bis 09/2017. Deskription der Zufriedenheit und Weiterempfehlung zu acht QS-Vergleichsgruppen. Facebook ermöglicht keine Zuordnung der Bewertungen zu Fachabteilungen, weshalb nur Kliniken mit je einer QS-VG berücksichtigt wurden. Ergebnisse Neben Rehabilitanden (95,4%) bewerten Angehörige (4,0%), sonstige Betroffene (0,5%), Klinikmitarbeiter und Einweiser auf Klinikbewertungen.de. Die Bewertungen auf offiziellen und inoffiziellen Facebookseiten sind zu 49,1% von Frauen und 38,5% von Männern. 75,8% empfehlen die Klinik weiter; 79,7% sind mit der Reha sehr zufrieden bis zufrieden. Die Rehabilitanden in der Onkologie (77,9%) sind zufriedener als in der Neurologie (59,0%), wohingegen die Angehörigen unzufriedener sind als die Rehabilitanden (58,4% vs. 18,6%). Die Qualität der Behandlung und Beratung wird positiver bewertet als die Verwaltungsabläufe und die Ausstattung. Fazit Die Online-Rehabilitandenzufriedenheit fällt vorwiegend positiv aus. Die Ergebnisse sind zeitnah verfügbar und bieten eine zusätzliche Informationsquelle für das QM. Publication Date: 02 September 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Background: Improving the transparency of information about the quality of health care providers is one way to improve health care quality. It is assumed that Internet information steers patients toward better-performing health care providers and will motivate providers to improve quality. However, the effect of public reporting on hospital quality is still small. One of the reasons is that users find it difficult to understand the formats in which information is presented. Objective: We analyzed the presentation of risk-adjusted mortality rate (RAMR) for coronary angiography in the 10 most commonly used German public report cards to analyze the impact of information presentation features on their comprehensibility. We wanted to determine which information presentation features were utilized, were preferred by users, led to better comprehension, and had similar effects to those reported in evidence-based recommendations described in the literature. Methods: The study consisted of 5 steps: (1) identification of best-practice evidence about the presentation of information on hospital report cards; (2) selection of a single risk-adjusted quality indicator; (3) selection of a sample of designs adopted by German public report cards; (4) identification of the information presentation elements used in public reporting initiatives in Germany; and (5) an online panel completed an online questionnaire that was conducted to determine if respondents were able to identify the hospital with the lowest RAMR and if respondents’ hospital choices were associated with particular information design elements. Results: Evidence-based recommendations were made relating to the following information presentation features relevant to report cards: evaluative table with symbols, tables without symbols, bar charts, bar charts without symbols, bar charts with symbols, symbols, evaluative word labels, highlighting, order of providers, high values to indicate good performance, explicit statements of whether high or low values indicate good performance, and incomplete data (“N/A” as a value). When investigating the RAMR in a sample of 10 hospitals’ report cards, 7 of these information presentation features were identified. Of these, 5 information presentation features improved comprehensibility in a manner reported previously in literature. Conclusions: To our knowledge, this is the first study to systematically analyze the most commonly used public reporting card designs used in Germany. Best-practice evidence identified in international literature was in agreement with 5 findings about German report card designs: (1) avoid tables without symbols, (2) include bar charts with symbols, (3) state explicitly whether high or low values indicate good performance or provide a “good quality” range, (4) avoid incomplete data (N/A given as a value), and (5) rank hospitals by performance. However, these findings are preliminary and should be subject of further evaluation. The implementation of 4 of these recommendations should not present insurmountable obstacles. However, ranking hospitals by performance may present substantial difficulties. [J Med Internet Res 2015;17(3):e68]

Physician Choice Making and Characteristics Associated With Using Physician-Rating Websites: Cross-Sectional Study

Eight Questions About Physician-Rating Websites: A Systematic Review