What publicly available quality metrics do hip and knee arthroplasty patients care about most when selecting a hospital in Maryland: A discrete choice experiment
PublisherBMJ Publishing Group
MetadataShow full item record
AbstractObjective 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.
SponsorsThis 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).
Keyworddiscrete choice experiment
hospital quality metrics
total hip and knee arthroplasty
Identifier to cite or link to this itemhttps://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
- Creating compact comparative health care information: what are the key quality attributes to present for cataract and total hip or knee replacement surgery?
- Authors: Damman OC, Spreeuwenberg P, Rademakers J, Hendriks M
- Issue date: 2012 Mar-Apr
- How do patients trade-off surgeon choice and waiting times for total joint replacement: a discrete choice experiment.
- Authors: Marshall DA, Deal K, Conner-Spady B, Bohm E, Hawker G, Loucks L, MacDonald KV, Noseworthy T
- Issue date: 2018 Apr
- [Current status of total hip and knee replacements in Germany - results of a nation-wide survey].
- Authors: Jaschinski T, Pieper D, Eikermann M, Steinhausen S, Linke C, Heitmann T, Pani M, Neugebauer E
- Issue date: 2014 Oct
- Effect of post-discharge venous thromboembolism on hospital quality comparisons following hip and knee arthroplasty.
- Authors: Kester BS, Merkow RP, Ju MH, Peabody TD, Bentrem DJ, Ko CY, Bilimoria KY
- Issue date: 2014 Sep 3
- Early recovery following lower limb arthroplasty: Qualitative interviews with patients undergoing elective hip and knee replacement surgery. Initial phase in the development of a patient-reported outcome measure.
- Authors: Strickland LH, Kelly L, Hamilton TW, Murray DW, Pandit HG, Jenkinson C
- Issue date: 2018 Jul