Insurees' preferences in hospital choice—A population-based study. Issue 10 (October 2017)

• Record Type: Journal Article
• Authors: Schuldt, Johannes; Doktor, Anna; Lichters, Marcel; Vogt, Bodo; Robra, Bernt-Peter
• Is Part Of: Health policy. Volume 121:Issue 10(2017)
• Page Start: 1040
• Page End: 1046
• Publication Date: 2017-10
• Subjects: Conjoint analysis -- Consumer segments -- Discrete choice -- Hospital choice -- Hospital selection -- Rating portals; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2017.08.004
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: Today consumer information on hospitals are better than ever. Little is known about consumer preferences in hospital choice. In this discrete choice study, the complication rate outweighs other hospital criteria tested. This finding is independent of age, gender, and other characteristics of the respondents. A small minority prefers accessibility to better treatment quality. Abstract: In Germany, the patient himself makes the choice for or against a health service provider. Hospital comparison websites offer him possibilities to inform himself before choosing. However, it remains unclear, how health care consumers use those websites, and there is little information about how preferences in hospital choice differ interpersonally. We conducted a Discrete-Choice-Experiment (DCE) on hospital choice with 1500 randomly selected participants (age 40–70) in three different German cities selecting four attributes for hospital vignettes. The analysis of the study draws on multilevel mixed effects logit regression analyses with the dependent variables: "chance to select a hospital" and "choice confidence". Subsequently, we performed a Latent-Class-Analysis to uncover consumer segments with distinct preferences. 590 of the questionnaires were evaluable. All four attributes of the hospital vignettes have a significant impact on hospital choice. The attribute "complication rate" exerts the highest impact on consumers' decisions and reported choice confidence. Latent-Class-Analysis results in one dominant consumer segment that considered the complication rate the most important decision criterion. Using DCE, we were able to show that the complication rate is an important trusted criterion in hospital choice to a large group of consumers. Our study supports current governmental efforts in Germany to concentrate the provision of specialized health care services. We suggest further national and cross-national research on the topic.