Choosing a hospital for obstetric, gynecologic, or reproductive healthcare: what matters most to patients?

Abstract

Despite millions of U.S. women receiving obstetric/gynecologic or reproductive care in a hospital each year, little is known about which factors matter most to women in choosing a hospital for this care. To describe women's reasons for choosing their hospital for obstetric/gynecologic or reproductive care, and to examine characteristics associated with reporting specific factors as important in hospital choice. We conducted a nationally representative, cross-sectional survey of women aged 18-45 years. The 2016 survey recruited women from AmeriSpeak, a probability-based research panel. A total of 1430 women completed the survey. All data analysis used weighting and accounted for the complex survey design. We conducted bivariate and multinomial logistic regression modeling to assess associations. Three-fourths of women cited a hospital's overall reputation/quality as a reason, and one-third named this as the most important reason for choosing a hospital. A total of 14% reported hospital religious affiliation as a reason. Compared to those with no prior deliveries, women who had delivered an infant were more likely to report that their top reason was specialty services/provider (relative risk ratio, 2.97; 95% confidence interval, 1.96-4.52) and were also more likely to report overall hospital quality/reputation as their top reason (relative risk ratio, 1.52; 95% confidence interval, 1.06-2.17), compared to logistical reasons. Metropolitan versus non-metropolitan residence was also a significant factor in hospital choice. Women endorse many factors when choosing a hospital for reproductive care, but perceived quality and reputation outweigh logistical concerns such as location and insurance.