Improving Patients' Choice of Clinician by Including Roll-up Measures in Public Healthcare Quality Reports: an Online Experiment
Improving Patients' Choice of Clinician by Including Roll-up Measures in Public Healthcare Quality Reports: an Online Experiment
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DOI：
10.1007/s11606-018-4725-y
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发表时间：
2019-02-01
影响因子：
5.7
通讯作者：
Martino, Steven C.
中科院分区：
文献类型：
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作者：
Cerully, Jennifer L.;Parker, Andrew M.;Martino, Steven C.
背景关于医疗质量的公共报告通常包括复杂的数据。为了降低解释这些数据的认知负担，一些报告设计者创建了汇总或汇总措施，将多个质量指标合并为一个分数。鲜为人知的是如何滚动的可用性影响clinical choice.Objectives确定如何呈现质量分数在不同水平的聚集影响患者的clinical choice.DesignWe进行了模拟临床医生选择实验，随机参与者三个版本的公共报告网站，并比较他们的临床医生的选择。一个版本将所有临床医生级别的质量指标汇总到汇总表中，（向下钻取）仅分数，第三种方法提供了上滚和下钻两种方法。实验者从基于概率的互联网小组中抽取了550名小组成员。主要测量方法我们通过跟踪在网站上花费的时间长度和在网站上采取的具体行动的数量来评估参与者所付出的努力量（例如，在一个实施例中，点击项目）。我们通过测量参与者是否选择了一个表现比其他人更差的临床医生以及参与者对质量维度的陈述偏好与他们选择的临床医生在这些维度上的表现之间的不一致性来评估决策质量。（平均值=14.9）或卷起（平均值=19.2）采取更多的行动比那些只看到卷起（平均值=10.5）（ps
BackgroundPublic reports on healthcare quality typically include complex data. To lower the cognitive burden of interpreting these data, some report designers create summary, or roll-up, measures combining multiple indicators of quality into one score. Little is known about how the availability of roll-ups affects clinician choice.ObjectiveTo determine how presenting quality scores at different levels of aggregation affects patients' clinician choices.DesignWe conducted a simulated clinician-choice experiment, randomizing participants to three versions of a public reporting website and comparing their clinician choices. One version aggregated all clinician-level quality measures into roll-ups, the second provided disaggregated (drill-down) scores only, and the third offered both roll-ups and drill-downs.ParticipantsFive hundred fifty panelists drawn from a probability-based Internet panel.Main MeasuresWe assessed the amount of effort participants exerted by tracking the length of time spent on the website and the number of concrete actions taken on the website (e.g., clicking items). We evaluated decision quality by measuring whether participants selected a clinician who performed more poorly than others and incongruence between participants' stated preferences for dimensions of quality and their chosen clinician's performance on those dimensions.Key ResultsParticipants seeing drill-downs alone (mean=14.9) or with roll-ups (mean=19.2) took more actions than those who saw roll-ups alone (mean=10.5) (ps