Published Work

Choosing a high-quality hospital

Public Deposited

the role of nudges, scorecard design and information.

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  • London
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  • The King's Fund
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  • 2010
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  • 88p.
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  • Patient choice, particularly the choice of hospital, has been at the heart of health policy for a number of years. The aim of this policy is to create competition, which in turn drives improvements in quality; for this to work effectively, patients have to make their choices on the basis of clinical quality. Significant resources have been devoted to offering patients more information to help them make their choices. But do people use the information that is available? Choosing a high-quality hospital explores how information can help patients to make informed choices. It is based on a research study, which began with a series of focus group discussions, the results of which informed the design of an online experiment. People were presented with information using a number of different ‘scorecards’ comparing the performance of hospital, and different ‘nudges’ were used to influence their choices. The research aimed to answer the following questions: What information do patients use when choosing a hospital? What is important to patients when choosing a hospital? How does the design of information influence the choices that patients make, and in particular, how can they be guided – using ‘nudges’ – to make better decisions? Do people make better choices as they become more practised in making decisions (ie, do they learn to make better choices)? The online experiment showed that making informed choices using comparative information on the quality of hospitals is difficult, even for people who are used to using the internet. The way in which information was presented on screen made a difference to people’s decisions - but the impact was not always as expected. Patients can be prompted to pay more attention to clinical quality, but the impact of specific prompts depend on a number of factors - for example, patients’ age, their level of education, etc. This report includes useful information for policy-makers and information providers, including practical suggestions as to how information can be presented and ordered in order to maximise the chances of decisions being made on the basis of quality.
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