Do Hospital Report Cards Affect Patient Choices?
Jason Shafrin reviews the literature and finds the evidence is mixed. Here is the latest study from the Netherlands:
The authors find that an improvement in overall reputation by one point — given an average score of 7.2 on a scale of 1–10, which implies an increase of 14 percent — would result in an increase in demand of 65 percent or 92 patients. The variation across individual hospitals is, however, substantial: the predicted increases in demand vary from 18 percent to 230 percent.
But Shafrin finds reasons to be skeptical even about this study.
So-called report cards that rate hospital quality are probably worthless. However, patients talking among themselves about customer service may be more useful. How quickly my doctor sees me once I arrive for an appointment is an aspect of care that I believe is useful for patients to discuss. How soon in the future my doctor can schedule an appointment when I call is another.
What the patients are used to would affect the score quite a bit I assume. For example, someone used to pretty good care (relatively) in a Manhattan urgent care center might come to Texas and get sub-par treatment in a similar facility and yet rate the Texas facility much higher due to the inherent differences in the relative quality of care between New York City and Texas.
I agree with the author and the commenters here: ranking hospitals seems to have far too many variables to meet any scientific basis of accuracy or reliability.
“Ranking” hospitals might be flawed, but some kind of a report card system could prove useful to consumers.
I wish health care economists would talk to the marketing guys. It is very difficult to change market share. Costs dont seem to matter much. Quality of care matters little, unless you have major adverse events getting into the papers.
Steve
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