Association Between Patient Value Systems and Physician and Practice Attributes Available Online.

JAMA facial plastic surgery 2018 Vol.20(2) p. 116-121

Welshhans JL, Harmon JJ, Papel I, Gentile R, Mangat D, Byrne P, Collar RM

Abstract

[IMPORTANCE] The relative value of facial plastic surgeon personal and practice attributes is relevant to the broader health care system because of increasing out-of-pocket expenses to patients.

[OBJECTIVE] To determine the relative value of specific facial plastic surgeon personal and practice attributes available online from the perspective of patients.

[DESIGN, SETTING, AND PARTICIPANTS] This study consisted of an electronic survey sent to patients by email using choice-based conjoint analysis; surveys were sent between December 2015 and March 2016. Participants had agreed to join email registries to be sent email surveys and promotions at 3 private facial plastic and reconstructive surgery practices. The following surgeon personal and practice attributes and levels were compared: (1) outcome transparency (above average, average, not available); (2) surgical training affiliations (US News and World Reports rankings); (3) online rating site scores (2 [poor], 3, or 4 [excellent] stars); and (4) price ($1×, $2×, and $3× [× = $1500; average cost was set at $2×]).

[MAIN OUTCOMES AND MEASURES] The relative importance of outcome transparency, surgical training affiliations, online rating scores, and price to prospective patients.

[RESULTS] Overall, 291 patients participated for a completion rate of 68%. Outcome transparency was the most valued attribute (attribute utility range = 141; attribute importance = 35.2%). Price was the least valued attribute (attribute utility range = 58.59; attribute importance = 15.1%). Assuming top-tier affiliations and 4-star ratings, share of market (SOM) was 75.5% for surgeons with above-average outcome transparency priced at $3× compared with those surgeons with no outcomes available priced at $1×. Holding price constant at $2×, surgeons with middle-tier affiliations and 2-star online ratings but above average outcomes achieved 48.4% SOM when compared with those surgeons with top-tier affiliations and 4-star online ratings without available outcomes.

[CONCLUSIONS AND RELEVANCE] Facial plastic surgery patients most value surgeons who publish outcomes. Moreover, they are willing to discount poor rating scores and lower-ranked institutional affiliations when outcome transparency is high. This study demonstrates that outcome transparency is crucial in facial plastic surgery markets.

[LEVEL OF EVIDENCE] NA.

추출된 의학 개체 (NER)

유형영어 표현한국어 / 풀이UMLS CUI출처등장
약물 [IMPORTANCE] The scispacy 1
약물 out-of-pocket scispacy 1
약물 [OBJECTIVE] scispacy 1
약물 [DESIGN scispacy 1
약물 [MAIN OUTCOMES AND scispacy 1
약물 [CONCLUSIONS AND RELEVANCE] Facial plastic surgery scispacy 1
질환 Physician scispacy 1
기타 Patient scispacy 1
기타 patients scispacy 1

MeSH Terms

Adult; Aged; Clinical Competence; Disclosure; Face; Female; Health Care Costs; Health Care Surveys; Humans; Internet; Male; Marketing of Health Services; Middle Aged; Patient Satisfaction; Practice Patterns, Physicians'; Social Values; Societies, Medical; Surgeons; Surgery, Plastic; United States