[The information needs of non-hospital based physicians regarding admissions and transfers]. / Informationsbedarf niedergelassener Ärzte bei Ein- und Überweisungen.

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.

[Do physicians know and use mandatory quality reports?]. / Kennen und nutzen ärzte den strukturierten qualitätsbericht?

OBJECTIVE: Physicians should be principal recipients of quality reports because they play a major role in referral decisions. The purpose of this study was to determine physicians' awareness and use of Germany's mandatory hospital quality reports. METHOD: A retrospective observational study was carried out through structured telephone interviews of a stratified random sample of 300 physicians working in ambulatory care in Germany. We analysed absolute and relative frequencies of physicians' awareness and use of quality reports. Additionally we analysed physicians' awareness and use of quality reports in relation to age, sex, specialty, practice type and region of practice using binary regression analysis. RESULTS: Less than half of the physicians were aware of the quality reports. Younger physicians were significantly more aware of the reports but did not use them more often than their older colleagues. Overall 10 % of the physicians already used them for counselling patients. Taking physicians' use of online comparative hospital guides into account, the combined total use was 14 %. CONCLUSIONS: Germany's mandatory hospital quality reports play only a minor role in physicians counselling of patients who need hospital care because too few physicians know and use the reports.

[Public reporting--forms and effects]. / Public Reporting -Formen und Effekte öffentlicher Qualitätsberichterstattung.

Since 2004 hospitals in Germany publish structured report cards bi-yearly. Content and scope of these mandatory public reports are still under discussion. Therefore we provide an up to date overview on forms and effects of public reports. By enabling transparency, comparative reports on the quality of health care aim at supporting patients to choose better performing health care providers and motivating health care providers to enhance quality improvement activities. Internationally existing public reports range from reports on national health systems on the whole to reports on the quality of particular procedures of individual health care providers. Contrary to the multitude of public reports, the evidence on the effects of public reporting remains scant. The few existing studies show that hospitals react on the public reports by some quality improvements. However, regarding the selection of providers and the quality of care they only show inconsistent effects of public reporting. Moreover, unsolved methodical problems of pubic reporting and potentially unintended consequences have to be considered. Therefore the question remains whether the expected effects in terms of quality improvements outbalance the unintended consequences in the long run and if the investments in public reporting will be paid off.