Where would you go for your next hospitalization?

We examine the effects of diverse dimensions of hospital quality - including consumers' perceptions of unobserved attributes - on future hospital choice. We utilize consumers' stated preference weights to obtain hospital-specific estimates of perceptions about unmeasured attributes such as reputation. We report three findings. First, consumers' perceptions of reputation and medical services contribute substantially to utility for a hospital choice. Second, consumers tend to select hospitals with high clinical quality scores even before the scores are publicized. However, the effect of clinical quality on hospital choice is relatively small. Third, satisfaction with a prior hospital admission has a large impact on future hospital choice. Our findings suggest that including measures of consumers' experience in report cards may increase their responsiveness to publicized information, but other strategies are needed to overcome the large effects of consumers' beliefs about other quality attributes.

[1]  Alan T. Sorensen,et al.  Information and Consumer Choice: The Value of Publicized Health Plan Ratings , 2005, Journal of health economics.

[2]  G. Torrance Measurement of health state utilities for economic appraisal. , 1986, Journal of health economics.

[3]  J. S. Long,et al.  Regression Models for Categorical and Limited Dependent Variables , 1997 .

[4]  M. Gustafsson Systematic Meaning and Linguistic Diversity: The Place of Meaning-Theories in Davidson's Later Philosophy , 1998 .

[5]  M. Morrisey,et al.  Death and reputation: how consumers acted upon HCFA mortality information. , 1997, Inquiry : a journal of medical care organization, provision and financing.

[6]  R. Feldman,et al.  Measuring consumer perceptions of quality differences among competing health benefit plans. , 2002, Journal of health economics.

[7]  F. Porell,et al.  Hospital Choice Models: A Review and Assessment of their Utility for Policy Impact Analysis , 1995, Medical care research and review : MCRR.

[8]  J. Christianson,et al.  Do consumers use information to choose a health-care provider system? , 2000, The Milbank quarterly.

[9]  Mark Shanley,et al.  Cost reductions or reputation enhancement as motives for mergers: The logic of multihospital systems , 1995 .

[10]  Melinda Beeuwkes Buntin,et al.  Choosing a Health Care Provider: The Role of Quality Information , 2008 .

[11]  David Dranove,et al.  Start spreading the news: a structural estimate of the effects of New York hospital report cards. , 2008, Journal of health economics.

[12]  J. Christianson,et al.  Do employees use report cards to assess health care provider systems? , 2001, Health services research.

[13]  Alvin I Mushlin,et al.  Quality Report Cards, Selection of Cardiac Surgeons, and Racial Disparities: A Study of the Publication of the New York State Cardiac Surgery Reports , 2004, Inquiry : a journal of medical care organization, provision and financing.

[14]  J. Christianson,et al.  Steering patients to safer hospitals? The effect of a tiered hospital network on hospital admissions. , 2008, Health services research.

[15]  J. Abraham,et al.  The effect of quality information on consumer health plan switching: evidence from the Buyers Health Care Action Group. , 2006, Journal of health economics.

[16]  D. Haas-wilson The relationships between the dimensions of health care quality and price: the case of eye care. , 1994, Medical care.

[17]  Michael P. Keane,et al.  A model of health plan choice:: Inferring preferences and perceptions from a combination of revealed preference and attitudinal data , 1998 .