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Observational Study
. 2017 Nov 13;17(1):720.
doi: 10.1186/s12913-017-2712-3.

Hospital choice in Germany from the patient's perspective: a cross-sectional study

Werner de Cruppé  1 , Max Geraedts  2
Affiliations
Observational Study

Hospital choice in Germany from the patient's perspective: a cross-sectional study

Werner de Cruppé et al. BMC Health Serv Res. .

Abstract

Background: In many countries health policy encourages patients to choose their hospital, preferably by considering information of performance reports. Previous studies on hospital choice mainly have focused on patients undergoing elective surgery. This study examined a representative sample of hospital inpatients across disciplines and treatment interventions in Germany. Its research questions were: How many patients decide where to go for hospital treatment? How much time do patients have before admission? Which sources of information do they use, and which criteria are relevant to their decision?

Methods: Cross-sectional observational study covering 1925 inpatients of 46 departments at 17 hospitals in 2012. The stratified survey comprised 11 medical disciplines (internal medicine, gynaecology, obstetrics, paediatrics, psychiatry, orthopaedics, neurology, urology, ENT and geriatrics) on 3 hospital care levels representing 91.9% of all hospital admissions to inpatient care in Germany in 2012. The statistical analysis calculated the frequency distributions and 95% confidence intervals of characteristics related to the hospital choice.

Results: 63.0% [60.9-65.2] of patients in Germany chose the hospital themselves, but only 21.1% [19.3-22.9] had more than one week to decide prior to admission. Major sources of information were personal knowledge of hospitals, relatives, outpatient health professionals and the Internet. Main criteria for the decision were personal experience with a hospital, recommendations from relatives and providers of outpatient services, a hospital's reputation and distance from home. Specific quality information as provided by performance reports were of secondary importance.

Conclusions: A majority of patients in the German health system choose their hospital freely. Providers of outpatient health care can have an important "agent" function in the quality-oriented hospital choice especially for patients with little time prior to admission and those who do not decide themselves. Hospitals have an impact on patients' future hospital choices by the treatment experience they provide to patients.

Keywords: Cross-sectional study; Decision-making; Germany; Hospital; Hospital choice; Hospitalisation; Patient autonomy.

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Conflict of interest statement

Ethics approval and consent to participate

The ethics committee at Witten/Herdecke University approved the study, reference number: 95/2010.

Patient informed consent was obtained by a first contact of the patient by the medical ward staff asking if the patient would consider participating in this study. Then the patient was given detailed information and his/her questions were answered by the interviewer in a face-to-face contact. All patients received as well a hand-out with a written information on the study and a consent form for their own purpose and a second consent form which they signed and returned before the interview took place.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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