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Do patients' information requirements for choice in health care vary with their socio-demographic characteristics?

ABSTRACT: This study examines whether the information used to inform hospital choice, and the sources of that information, varies with patients' socio-demographic characteristics. It also examines whether information used by patients to inform choice is associated with attending their local hospital.A survey of 1033 patients who were offered a choice of hospital provider for elective treatment in England. Logistic regression was used to examine associations between patient characteristics and information used to inform choice of a hospital provider and sources of information used.Factors most important to patients in choosing a hospital were quality of care, cleanliness, standard of facilities and reputation. While quality of care and related factors are important to the majority of patients, those with lower levels of education were more likely to report that location and appointment times were important. Those who thought quality important were more likely to attend their local hospital provider. The main sources of information used to inform choice of hospital were own experience, family and friends and the general practitioner (GP). Patients who sought advice from their GP or booking advisors were less likely to attend their local hospitals.Differences among patients as to what factors are important when choosing a hospital provider and what information and support they access suggest there needs to be a variety of information sources and support available to promote choice. Greater shared decision making through active involvement and support by GPs or booking advisors may be required if they are to make choices in line with their preferences.

SUBMITTER: Laverty AA

PROVIDER: S-EPMC5060873 | biostudies-other | 2015 Oct

REPOSITORIES: biostudies-other

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Do patients' information requirements for choice in health care vary with their socio-demographic characteristics?

Laverty Anthony A AA Dixon Anna A Millett Christopher C

Health expectations : an international journal of public participation in health care and health policy 20130528 5

<h4>Objectives</h4>This study examines whether the information used to inform hospital choice, and the sources of that information, varies with patients' socio-demographic characteristics. It also examines whether information used by patients to inform choice is associated with attending their local hospital.<h4>Methods</h4>A survey of 1033 patients who were offered a choice of hospital provider for elective treatment in England. Logistic regression was used to examine associations between patie ...[more]

PMID: 23711113

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Project description:BackgroundUnderstanding how patient-reported experiences of care and overall rating of care vary among patients with different characteristics is useful to help interpret results from patient experience surveys and design targeted improvement interventions. The primary objective of this paper was to identify the socio-demographic and health-related characteristics independently associated with overall rating of cancer care. The secondary objective was to explore if and how these characteristics were associated with specific experiences of cancer care.MethodsThis cross-sectional multicenter study analyzed self-reported data collected from 2696 patients diagnosed with breast, prostate, lung, colorectal, skin, or hematological cancer from four large hospitals in French-speaking Switzerland. Multivariate logistic regressions with purposeful stepwise selection of independent variables were used to identify the socio-demographic and health-related characteristics independently associated with overall rating of cancer care in the primary analyses. In the secondary analyses, we ran the multivariate model from the primary analyses with specific experiences of care as outcomes to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) of the selected characteristics.ResultsRespondents' mean rating of overall cancer care was 8.5 on a scale from 0 to 10, with 17% categorized as reporting a low rating (0-7 rating). Being a woman (OR 1.43, 95% CI 1.12-1.83), not being Swiss (OR 1.47, 95% CI 1.12-1.94), reporting lower health literacy (OR 1.95, 95% CI 1.54-2.47), preferring making medical decisions alone (OR 1.92, 95% CI 1.38-2.67), having forgone care due to cost (OR 1.72, 95% CI 1.29-2.29), having used complementary medicine (OR 1.55, 95% CI 1.22-1.97), and reporting poorer health (OR 3.12, 95% CI 2.17-4.50) were all independently associated with a low rating of overall cancer care. Poorer health, lower health literacy, and having forgone care were the three characteristics most often associated with problematic experiences of care.ConclusionsOur results identified several patient characteristics consistently associated with lower overall rating of care and specific experiences of cancer care. Among these determinants, health literacy and financial hardship emerged as key recurring factors shaping poor patient experiences that should be prioritized for attention by cancer care services.

Project description:BackgroundAlthough hospitals are increasingly held accountable for patients' post-discharge outcomes, giving them incentive to help patients choose high-performing home health agencies, little is known about how quality reports inform decision making.ObjectiveWe aimed to learn how quality reports are used when choosing home care in one northeast state (Rhode Island) .DesignThe study consisted of focus groups with home health consumers and structured interviews with hospital case managers.ParticipantsThirteen consumers and 28 case managers from five hospitals participated in the study.ApproachWe identified key themes and illustrative quotes by audiotaping each session, and then three independent reviewers conducted repeated examination and content analysis.Key resultsNo participants were aware of existing state or Medicare home health agency public reports. Case managers provided agency lists to consumers, who routinely asked case managers to tell them which agencies to choose or which were best; but case managers felt unable to directly respond to consumers' requests for help in making the choice, because they did not have additional information to provide and because they feared violating federal laws requiring freedom of patient choice. Case managers also felt that there was little difference in agency quality, although they acknowledged they might not be aware of problems related to post-hospital care.ConclusionsHome health consumers and hospital case managers were unaware of public reports about home health quality, which limited consumers' ability to make informed decisions and case managers' ability to assist them in that decision-making process. Case managers were otherwise prohibited from recommending specific providers to patients and viewed the 'patient choice' laws as restricting their ability to respond to patients' requests for help in choosing home health agencies. Public reports can be marketed as tools that case managers can use to help patients differentiate among providers, while supporting patient autonomy.

Project description:ObjectiveTo estimate food insecurity (FI) prevalence among UK adults and investigate associations with socio-demographic characteristics, diet and health.DesignWeighted cross-sectional survey data. FI was measured using the USDA Adult Food Security Survey Module. Data were analysed using adjusted logistic regression models.SettingUnited Kingdom.Participants2551 participants (aged 18-64 years); sub-sample (n 1949) used to investigate association between FI and overweight.ResultsFI prevalence was 24·3 %. Higher odds of FI were observed among participants who reported that making ends meet was difficult v. easy (OR 19·76, 95 % CI 13·78, 28·34), were full-time students v. non-students (OR 3·23, 95 % CI 2·01, 5·18), had low v. high education (OR 2·30, 95 % CI 1·66, 3·17), were male v. female (OR 1·36, 95 % CI 1·01, 1·83) and reported their ethnicity as mixed (OR 2·32, 95 % CI 1·02, 5·27) and white other (OR 2·04, 95 % CI 1·04, 3·99) v. white British. Odds of FI were higher in participants living with children v. alone, especially in single-parent households (OR 2·10, 95 % CI 1·19, 3·70). Odds of FI decreased per year of increase in age (OR 0·95, 95 % CI 0·94, 0·96) and were lower in participants not looking for work v. full-time employed (OR 0·60, 95 % CI 0·42, 0·87). Food insecure v. food secure adults had lower odds of consuming fruits (OR 0·59, 95 % CI 0·47, 0·74) and vegetables (OR 0·68, 95 % CI 0·54, 0·86) above the median frequency, and higher odds for fruit juice (OR 1·39, 95 % CI 1·10, 1·75). Food insecure v. food secure adults had higher odds of reporting unhealthy diets (OR 1·65, 95 % CI 1·31, 2·10), poor general health, (OR 1·90, 95 % CI 1·50, 2·41), poor mental health (OR 2·10, 95 % CI 1·64, 2·69), high stress (OR 3·15, 95 % CI 2·42, 4·11) and overweight (OR 1·32, 95 % CI 1·00, 1·75).ConclusionsFI prevalence was high and varied by socio-demographic characteristics. FI was associated with poorer diet and health.

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Do patients' information requirements for choice in health care vary with their socio-demographic characteristics?

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Do patients' information requirements for choice in health care vary with their socio-demographic characteristics?

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