Abstract
BackgroundConsumers are increasingly exposed to comparative healthcare information (information about the quality of different healthcare providers). Partly because of its complexity, the use of this information has been limited. The objective of this study was to examine how the amount of presented information influences the comprehension and use of comparative healthcare information when important consumer characteristics and skills are taken into account.MethodsIn this randomized controlled experiment, comparative information on total hip or knee surgery was used as a test case. An online survey was distributed among 800 members of the NIVEL Insurants Panel and 76 hip- or knee surgery patients. Participants were assigned to one of four subgroups, who were shown 3, 7, 11 or 15 quality aspects of three hospitals. We conducted Kruskall-Wallis tests, Chi-square tests and hierarchical multiple linear regression analyses to examine relationships between the amount of information and consumer characteristics and skills (literacy, numeracy, active choice behaviour) on one hand, and outcome measures related to effectively using information (comprehension, perceived usefulness of information, hospital choice, ease of making a choice) on the other hand.Results414 people (47%) participated. Regression analysis showed that the amount of information slightly influenced the comprehension and the perceived usefulness of comparative healthcare information. It did not affect consumers’ hospital choice and ease of making this choice. Consumer characteristics (especially age) and skills (especially literacy) were the most important factors affecting the comprehension of information and the ease of making a hospital choice. For the perceived usefulness of comparative information, active choice behaviour was the most influencing factor.ConclusionThe effects of the amount of information were not unambiguous. It remains unclear what the ideal amount of quality information to be presented would be. Reducing the amount of information will probably not automatically result in more effective use of comparative healthcare information by consumers. More important, consumer characteristics and skills appeared to be more influential factors contributing to information comprehension and use. Consequently, we would suggest that more emphasis on improving consumers’ skills is needed to enhance the use of comparative healthcare information.
Highlights
Consumers are increasingly exposed to comparative healthcare information
We examined the effects of the amount of information presented and consumer characteristics and skills on several indicators of effective information use, namely comprehension of information, the choice itself, ease of making a choice and the perceived usefulness of the information
We showed three types of quality aspects which are all used for actual comparative healthcare information in the Netherlands: patient experiences, hospital services and clinical performance
Summary
Consumers are increasingly exposed to comparative healthcare information (information about the quality of different healthcare providers). Consumers are interested in comparative healthcare information [5,6,7,8,9], multiple studies demonstrated that the use of this information has been limited [3,4] and there is limited evidence of an effect on consumer choice [3,10,11] Several explanations for this lack of use have been suggested, the most important being the complexity of the information as well as lacking skills of consumers [4,10,12,13]. Researchers in the field of comparative healthcare quality information have called for presenting only a limited amount of the available information [1,2,20]
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