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DOI: 10.1055/s-0032-1327745
Informationsbedarf niedergelassener Ärzte bei Ein- und Überweisungen
The Information Needs of Non-Hospital Based Physicians Regarding Admissions and TransfersPublication History
Publication Date:
05 April 2013 (online)
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Zusammenfassung
Studienziel:
Die Studie untersucht, welche Qualitätskriterien aus Sicht niedergelassener Ärzte von Relevanz sind, um Patienten qualitätsorientierte Empfehlungen zur Wahl eines geeigneten Krankenhauses oder Facharztes zu geben.
Methode:
Telefonische Primärbefragung von 300 Ärzten aus 5 Facharztgruppen zu ihrer Relevanzbeurteilung von 59 Qualitätskriterien von Krankenhäusern und Haus- bzw. Facharztpraxen. Die Auswertung erfolgte deskriptiv sowie bi- und multivariat mittels McNemar-Tests, Korrelations- und Regressionsanalysen.
Ergebnisse:
Neben den persönlichen Erfahrungen, die der Arzt und seine Patienten in der Vergangenheit mit dem Krankenhaus bzw. der Praxis gemacht haben, besteht ein grundsätzliches Interesse an wichtigen Struktur- und Ergebnisparametern von Krankenhäusern und Arztpraxen. Weniger relevant schätzen Ärzte Art und Umfang von Leistungs- und Serviceangeboten der Krankenhäuser und Praxen ein. Bei 12 der 59 untersuchten Qualitätskriterien unterscheiden sich die Relevanzbeurteilungen je nachdem, ob es sich um eine Ein- oder Überweisung handelt. Bei der Analyse möglicher Zusammenhänge zwischen Präferenzen und potentiellen arztseitigen Einflussfaktoren konnten für Geschlechts-, Alters- und Facharztgruppen spezifische Unterschiede ermittelt werden.
Abstract
Background:
This study examines the quality criteria which, from the perspective of non-hospital based physicians, are relevant in order to give patients quality-oriented recommendations in the selection of a suitable hospital or specialist.
Methods:
A primary telephone survey of 300 physicians from 5 specialist groups collected relevance assessments of 59 quality criteria for hospitals, GPs and specialist practices. A descriptive bi- and multivariate analysis was performed using McNemar tests, correlation and regression analysis.
Results:
Next to the personal experiences which the physician and his patients made with the hospital or non-hospital based colleague in the past, there is a general interest in vital structural and outcome parameters of hospitals and medical practices. Physicians deem the nature and scope of services offered by the hospitals and medical practices as less relevant. In 12 of the 59 examined quality criteria, the relevance assessments differ depending on whether the physician is dealing with an elective admission to hospital or a referral to a GP or specialist. In the analysis of possible correlations between preferences and factors which might be influencing the physician, gender, age and specialisation were found to have an effect.
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Literatur
- 1 Hibbard JH, Stockard J, Tusler M. Does publicizing hospital performance stimulate quality improvement efforts?. Health Aff 2003; 22: 84-94
- 2 Marshall MN, Shekelle PG, Leatherman S et al. The public release of performance data – what do we expect to gain? A Review of the Evidence. Jama 2000; 14: 1874-1899
- 3 Audet AMJ, Doty MM, Shamasdin J et al. Measure, learn, and improve: physicians’ involvement in quality improvement. Health Aff 2005; 24: 843 -853
- 4 Shaller D, Sofaer S, Findlay SD et al. Consumers and quality-driven health care: a call to action. Health Aff 2003; 22: 95 -101
- 5 Schneider EC, Epstein AM. Influence of cardiac-surgery performance reports on referral practices and access to care. A survey of cardiovascular specialists. N Engl J Med 1996; 335: 251-256
- 6 Schwartz LM, Woloshin S, Birkmeyer JD. How do elderly patients decide where to go for major surgery? Telephone interview survey. BMJ 2005; 331: 821
- 7 Leister J, Stausberg J. Why do patients select a hospital? A conjoint analysis in two German hospitals. J Hosp Mark Public Relations 2007; 17: 13-31
- 8 Wilson CT, Woloshin S, Schwartz LM. Choosing where to have major surgery: who makes the decision?. Arch Surg 2007; 142: 242-246
- 9 Geraedts M. Informationsbedarf und Informationssuchverhalten bei der Arztsuche. In: Böcken J, Braun B, Amhof R. Hrsg Gesundheitsmonitor 2008 – Gesundheitsversorgung und Gestaltungsoptionen aus der Perspektive der Bevölkerung. Bertelsmann Stiftung. 2008
- 10 Schneider EC, Epstein AM. Influence of cardiac-surgery performance reports on referral practices and access to care. a survey of cardiovascular specialists. N Engl J Med 1996; 335: 251-256
- 11 Brien SE, Dixon E, Ghali WA. Measuring and reporting on quality in health care: A framework and road map for improving care. Journal of Surgical Oncology 2009; 99: 462-466
- 12 Lako CJ, Rosenau P. Demand-driven care and hospital choice. Dutch health policy toward demand-driven care: results from a survey into hospital choice. Health Care Anal 2009; 17: 20-35
- 13 Kinchen KS, Cooper LA, Levine D et al. Referral of patients to specialists: factors affecting choice of specialist by primary care physicians. Ann Fam Med 2004; 2: 245-252
- 14 Rider EA, Perrin JM. Performance profiles: the influence of patient satisfaction data on physicians’ practice. Pediatrics 2002; 109: 752-757
- 15 Jung HP, Wensing M, Olesen F et al. Comparison of patients’ and general practitioners’ evaluations of general practice care. Qual Saf Health Care 2002; 11: 315-319
- 16 Javalgi R, Joseph WB, Gombeski WR et al. How physicians make referrals. J Health Care Mark 1993; 13: 6-17
- 17 Barr JK, Bernard SL, Sofaer S et al. Physicians’ views on public reporting of hospital quality data. Medical Care Research and Review 2008; 65: 655-673
- 18 Marshall MN, Hiscock J, Sibbald B. Attitudes to the public release of comparative information on the quality of general practice care: qualitative study. BMJ. 2002 325. 1278
- 19 Narins CR, Dozier AM, Ling FS et al. The influence of public reporting of outcome data on medical decision making by physicians. Arch Intern Med 2005; 165: 83-87
- 20 Schneider EC, Epstein AM. Influence of cardiac-surgery performance reports on referral practices and access to care. A survey of cardiovascular specialists. N Engl J Med 1996; 335: 251-256
- 21 Roter DL, Hall JA, Aoki Y. Physician gender effects in medical communication. JAMA 2002; 288: 756-764
- 22 Law SA, Britten N. Factors that influence the patient centredness of a consultation. Br J Gen Pract 1995; 45: 520-524
- 23 Meeuwesen L, Schaap C, van der Staak C. Verbal analysis of doctor-patient communication. Soc Sci Med 1991; 32: 1143-1150
- 24 Geraedts M, Schwartze D, Molzahn T. Hospital quality reports in Germany: patient and physician opinion of the reported quality indicators. BMC Health Serv Res 2007; 7: 157
- 25 Hensen P, Schiller M, Metze D et al. Evaluating hospital service quality from a physician viewpoint. Int J Health Care Qual Assur 2008; 21: 75-86
- 26 McBride CA, Shugars DA, DiMatteo MR et al. The physician’s role: views of the public and the profession on seven aspects of patient care. Arch Fam Med 1994; 3: 948-953
- 27 Laine C, Davidoff F, Lewis CE et al. Important elements of outpatient care: a comparison of patients’ and physicians’ opinions Ann Intern. Med 1996; 125: 640-645
- 28 Covinsky KE, Bates CK, Davis RB et al. Physicians’ attitudes toward using patient reports to assess quality of care. Academic Medicine 1996; 12: 1353-1356
- 29 Audet A-M, Davis K, Schoenbaum SC. Adoption of Patient-Centered Care Practices by Physicians. Results From a National Survey. Arch Intern Med 2006; 166: 754-759
- 30 Weismann CS, Teitlbaum MT. Physician gender and the physician-patient relationship: recent evidence and relevant questions. Soc Sci Med 1985; 20: 1119-1127