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. 2004 Apr;13(2):98–101. doi: 10.1136/qshc.2003.006981

Physician performance information and consumer choice: a survey of subjects with the freedom to choose between doctors

S Cheng 1, H Song 1
PMCID: PMC1743817  PMID: 15069215

Abstract

Background: Increasing efforts have been made to provide information to help consumers to select a healthcare provider, but the public release of hospital performance data has had only a limited impact on consumer choice.

Objectives: To understand the experience of consumers in searching for physician performance information and to investigate the potential impact on their propensity to change doctors if hypothetically provided with physician specific performance information.

Design: A nationwide telephone interview survey using a structured questionnaire.

Setting: The survey was conducted in Taiwan, a country with a universal health insurance programme where residents are free to choose between physicians for any medical consultation.

Participants: 4015 adults aged over 20 years contacted by random digit dialling telephone calls.

Main outcome measures: Subjects were asked (1) if they have ever compared the quality of care provided by physicians in their area; (2) if they would consult a performance report if it was available; and (3) if they would change doctors on the basis of information provided in the report.

Results: Approximately half the subjects had made comparisons between doctors; 73% stated that they would consult a performance report if it was available, and 77% were prepared to change doctors if their doctor performed badly in the report.

Conclusions: Providing physician specific performance reports to the public may be viewed favourably by consumers of health care and have a significant impact on physician selection and hence quality improvement.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anell A., Rosén P., Hjortsberg C. Choice and participation in the health services: a survey of preferences among Swedish residents. Health Policy. 1997 May;40(2):157–168. doi: 10.1016/s0168-8510(96)00891-3. [DOI] [PubMed] [Google Scholar]
  2. Beaulieu Nancy Dean. Quality information and consumer health plan choices. J Health Econ. 2002 Jan;21(1):43–63. doi: 10.1016/s0167-6296(01)00126-6. [DOI] [PubMed] [Google Scholar]
  3. Cheng S. H., Chiang T. L. The effect of universal health insurance on health care utilization in Taiwan. Results from a natural experiment. JAMA. 1997 Jul 9;278(2):89–93. doi: 10.1001/jama.278.2.89. [DOI] [PubMed] [Google Scholar]
  4. Cheng Shou-Hsia, Ho Yi-Chen, Chung Kuo-Piao. Hospital quality information for patients in Taiwan: can they understand it? Int J Qual Health Care. 2002 Apr;14(2):155–160. doi: 10.1093/oxfordjournals.intqhc.a002602. [DOI] [PubMed] [Google Scholar]
  5. Cleary P. D. The increasing importance of patient surveys. Now that sound methods exist, patient surveys can facilitate improvement. BMJ. 1999 Sep 18;319(7212):720–721. doi: 10.1136/bmj.319.7212.720. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Davies H. T., Marshall M. N. Public disclosure of performance data: does the public get what the public wants? Lancet. 1999 May 15;353(9165):1639–1640. doi: 10.1016/s0140-6736(99)90047-8. [DOI] [PubMed] [Google Scholar]
  7. Donabedian A. The quality of care. How can it be assessed? JAMA. 1988 Sep 23;260(12):1743–1748. doi: 10.1001/jama.260.12.1743. [DOI] [PubMed] [Google Scholar]
  8. Eddy D. M. Performance measurement: problems and solutions. Health Aff (Millwood) 1998 Jul-Aug;17(4):7–25. doi: 10.1377/hlthaff.17.4.7. [DOI] [PubMed] [Google Scholar]
  9. Fowles J. B., Kind E. A., Braun B. L., Knutson D. J. Consumer responses to health plan report cards in two markets. Med Care. 2000 May;38(5):469–481. doi: 10.1097/00005650-200005000-00004. [DOI] [PubMed] [Google Scholar]
  10. Goldstein E., Fyock J. Reporting of CAHPS quality information to medicare beneficiaries. Health Serv Res. 2001 Jul;36(3):477–488. [PMC free article] [PubMed] [Google Scholar]
  11. Guadagnoli E., Epstein A. M., Zaslavsky A., Shaul J. A., Veroff D., Fowler F. J., Jr, Cleary P. D. Providing consumers with information about the quality of health plans: the Consumer Assessment of Health Plans demonstration in Washington State. Jt Comm J Qual Improv. 2000 Jul;26(7):410–420. doi: 10.1016/s1070-3241(00)26034-3. [DOI] [PubMed] [Google Scholar]
  12. Hibbard J. H., Harris-Kojetin L., Mullin P., Lubalin J., Garfinkel S. Increasing the impact of health plan report cards by addressing consumers' concerns. Health Aff (Millwood) 2000 Sep-Oct;19(5):138–143. doi: 10.1377/hlthaff.19.5.138. [DOI] [PubMed] [Google Scholar]
  13. Hibbard J. H., Jewett J. J., Legnini M. W., Tusler M. Choosing a health plan: do large employers use the data? Health Aff (Millwood) 1997 Nov-Dec;16(6):172–180. doi: 10.1377/hlthaff.16.6.172. [DOI] [PubMed] [Google Scholar]
  14. Marshall M. N., Shekelle P. G., Leatherman S., Brook R. H. The public release of performance data: what do we expect to gain? A review of the evidence. JAMA. 2000 Apr 12;283(14):1866–1874. doi: 10.1001/jama.283.14.1866. [DOI] [PubMed] [Google Scholar]
  15. Mukamel D. B., Mushlin A. I. The impact of quality report cards on choice of physicians, hospitals, and HMOs: a midcourse evaluation. Jt Comm J Qual Improv. 2001 Jan;27(1):20–27. doi: 10.1016/s1070-3241(01)27003-5. [DOI] [PubMed] [Google Scholar]
  16. Peabody J. W., Yu J. C., Wang Y. R., Bickel S. R. Health system reform in the Republic of China. Formulating policy in a market-based health system. JAMA. 1995 Mar 8;273(10):777–781. [PubMed] [Google Scholar]
  17. Robinson S., Brodie M. Understanding the quality challenge for health consumers: the Kaiser/AHCPR Survey. Jt Comm J Qual Improv. 1997 May;23(5):239–244. doi: 10.1016/s1070-3241(16)30313-3. [DOI] [PubMed] [Google Scholar]
  18. Schauffler H. H., Mordavsky J. K. Consumer reports in health care: do they make a difference? Annu Rev Public Health. 2001;22:69–89. doi: 10.1146/annurev.publhealth.22.1.69. [DOI] [PubMed] [Google Scholar]
  19. Schneider E. C., Epstein A. M. Use of public performance reports: a survey of patients undergoing cardiac surgery. JAMA. 1998 May 27;279(20):1638–1642. doi: 10.1001/jama.279.20.1638. [DOI] [PubMed] [Google Scholar]
  20. Spranca M., Kanouse D. E., Elliott M., Short P. F., Farley D. O., Hays R. D. Do consumer reports of health plan quality affect health plan selection? Health Serv Res. 2000 Dec;35(5 Pt 1):933–947. [PMC free article] [PubMed] [Google Scholar]

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