Does quality influence choice of hospital?
Does quality influence choice of hospital?
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DOI：
10.1001/jama.1990.03440210049031
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发表时间：
1990-06
期刊：
影响因子：
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通讯作者：
Harold S. Luft;Deborah W. Garnick;David H. Mark;D. J. Peltzman;C. Phibbs;Erik Lichtenberg;Stephen J. McPhee
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文献类型：
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作者：
Harold S. Luft;Deborah W. Garnick;David H. Mark;D. J. Peltzman;C. Phibbs;Erik Lichtenberg;Stephen J. McPhee
近年来，许多信息已提供给公众和医生的医院质量衡量的病人的结果。为了检验在这些公开数据发布之前，质量是否会影响医院对转诊或收治医生和患者的吸引力，我们估计了1983年加州三个地理区域的医院中，质量、收费、所有权和距离对患者选择医院的影响，这些患者接受了七种外科手术和五种医疗诊断。更大的距离和公共或专有所有权一贯减少选择的可能性，而医学院的联系增加了选择的可能性。对于七分之五的外科手术和五分之二的医疗诊断，结果比预期差的医院吸引的入院人数明显减少。相反的情况适用于两种外科手术和一种医疗诊断。结果表明，即使在明确的数据被广泛使用之前，质量在医院之间的选择中也发挥了重要作用。
In recent years, much information has been provided to the public and to physicians about hospital quality measured in terms of patient outcomes. To examine if, before these public data releases, quality influenced the attractiveness of a hospital to referring or admitting physicians and to patients, we estimated the influences of quality, charges, ownership, and distance on the choice of hospitals for patients with seven surgical procedures and five medical diagnoses in hospitals in three geographic areas in California in 1983. Greater distance and public or proprietary ownership consistently reduced the likelihood of selection while medical school affiliation increased the likelihood of selection. For five of seven surgical procedures and two of five medical diagnoses, hospitals with poorer than expected outcomes attracted significantly fewer admissions. The reverse held for two surgical procedures and one medical diagnosis. The results suggest that quality played an important role in choices among hospitals even before explicit data were widely available.