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    What publicly available quality metrics do hip and knee arthroplasty patients care about most when selecting a hospital in Maryland: A discrete choice experiment

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    Author
    O'Hara, L.M.
    Caturegli, I.
    O'Hara, N.N.
    Date
    2019
    Journal
    BMJ Open
    Publisher
    BMJ Publishing Group
    Type
    Article
    
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    Show full item record
    See at
    https://doi.org/10.1136/bmjopen-2018-028202
    Abstract
    Objective To quantify which publicly reported hospital quality metrics have the greatest impact on a patient's simulated hospital selection for hip or knee arthroplasty. Design Discrete choice experiment. Setting Two university-affiliated orthopaedic clinics in the greater Baltimore area, Maryland, USA. Participants One hundred and twenty-eight patients who were candidates for total hip or knee arthroplasty. Primary and secondary outcome measures The effect and magnitude of acceptable trade-offs between publicly reported hospital quality parameters on patients' decision-making strategies using a Hierarchical Bayes model. Results Publicly reported information on patient perceptions of attention to alleviation of postoperative pain had the most influence on simulated hospital choice (20.7%), followed by methicillin-resistant Staphylococcus aureus (MRSA) rates (18.8%). The understandability of the discharge instructions was deemed the least important attribute with a relative importance of 6.9%. Stratification of these results by insurance status and duration of pain prior to surgery revealed that patient demographics and clinical presentation affect the decision-making paradigm. Conclusions Publicly available information regarding hospital performance is of interest to hip and knee arthroplasty patients. Patients are willing to accept suboptimal understanding of discharge instructions, lower hospital ratings and suboptimal cleanliness in exchange for better postoperative pain management, lower MRSA rates, and lower complication rates. Copyright Author(s) (or their employer(s)) 2019.
    Sponsors
    This work was supported by 5K24AI079040-05 (ADH) from the National Institutes of Health (NIH), and the Banting Postdoctoral Fellowship Program administered by the Government of Canada (LMO).
    Keyword
    discrete choice experiment
    hospital quality metrics
    Patient preferences
    total hip and knee arthroplasty
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85065992978&doi=10.1136%2fbmjopen-2018-028202&partnerID=40&md5=7a3d826972721effd9d38e5af91d0428; http://hdl.handle.net/10713/10818
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjopen-2018-028202
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