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Does quality influence choice of hospital?
H S Luft1, D W Garnick, D H Mark
1Institute for Health Policy Studies, University of California, San Francisco 94141-0936.
JAMA
|June 6, 1990
Summary
Hospital quality, measured by patient outcomes, influenced patient choice even before public data releases. Poorer outcomes deterred admissions, suggesting quality played a key role in hospital selection.
Area of Science:
- Health Services Research
- Medical Economics
- Healthcare Management
Background:
- Public reporting of hospital quality based on patient outcomes has increased.
- Understanding factors influencing hospital choice before public data availability is crucial.
Purpose of the Study:
- To examine if hospital quality influenced patient and physician choice before public data releases.
- To assess the impact of quality, charges, ownership, and distance on hospital selection.
Main Methods:
- Analysis of hospital choices for surgical and medical diagnoses in California in 1983.
- Estimation of influences including quality (patient outcomes), charges, ownership, and distance.
Main Results:
- Greater distance and public/proprietary ownership decreased hospital selection likelihood.
- Medical school affiliation increased selection likelihood.
- Poorer patient outcomes significantly reduced admissions for most procedures and diagnoses.
Conclusions:
- Hospital quality, indicated by patient outcomes, was a significant factor in hospital choice prior to widespread public data availability.
- Factors beyond quality, such as distance and ownership, also influenced selection.
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