The elicitation of patient and physician preferences for calculating consumer-based composite measures on hospital report cards: results of two discrete choice experiments

Abstract

Purpose

The calculation of aggregated composite measures is a widely used strategy to reduce the amount of data on hospital report cards. Therefore, this study aims to elicit and compare preferences of both patients as well as referring physicians regarding publicly available hospital quality information

Methods

Based on systematic literature reviews as well as qualitative analysis, two discrete choice experiments (DCEs) were applied to elicit patients’ and referring physicians’ preferences. The DCEs were conducted using a fractional factorial design. Statistical data analysis was performed using multinomial logit models

Results

Apart from five identical attributes, one specific attribute was identified for each study group, respectively. Overall, 322 patients (mean age 68.99) and 187 referring physicians (mean age 53.60) were included. Our models displayed significant coefficients for all attributes (p < 0.001 each). Among patients, “Postoperative complication rate” (20.6%; level range of 1.164) was rated highest, followed by “Mobility at hospital discharge” (19.9%; level range of 1.127), and ‘‘The number of cases treated” (18.5%; level range of 1.045). In contrast, referring physicians valued most the ‘‘One-year revision surgery rate’’ (30.4%; level range of 1.989), followed by “The number of cases treated” (21.0%; level range of 1.372), and “Postoperative complication rate” (17.2%; level range of 1.123)

Conclusion

We determined considerable differences between both study groups when calculating the relative value of publicly available hospital quality information. This may have an impact when calculating aggregated composite measures based on consumer-based weighting.