Download PDF
Methods Inf Med 2012; 51(02): 112-120
DOI: 10.3414/ME11-01-0045
Original Articles
Schattauer GmbH

Public Reporting in Germany: the Content of Physician Rating Websites[*]

M. Emmert
1   Friedrich-Alexander-University Erlangen-Nuremberg, Chair of Health Management, Nuremberg, Germany:
,
U. Sander
2   University of Applied Sciences and Arts, Hannover, Germany
,
A. S. Esslinger
3   University of Applied Sciences Aalen, Germany and Friedrich-Alexander-University Erlangen-Nuremberg, Chair of Strategic Management, Nuremberg, Germany
,
M. Maryschok
1   Friedrich-Alexander-University Erlangen-Nuremberg, Chair of Health Management, Nuremberg, Germany:
,
O. Schöffski
1   Friedrich-Alexander-University Erlangen-Nuremberg, Chair of Health Management, Nuremberg, Germany:
› Author Affiliations
Further Information

Publication History

received:20 May 2011

accepted:26 August 2011

Publication Date:
19 January 2018 (online)

    Permissions and Reprints

Summary

Background: Physician rating websites (PRWs) are gaining in popularity among patients seeking quality information about physicians. However, little knowledge is available about the quantity and type of information provided on the websites.

Objective: To determine and structure the quantity and type of information about physicians in the outpatient sector provided on German-language physician rating websites.

Methods: In a first step, we identified PRWs through a systematic internet search using German keywords from a patient´s perspective in the two search engines Google and Yahoo. Afterwards, information about physicians available on the websites was collected and categorised according to Donabedian´s structure/process/outcome model. Furthermore, we investigated whether the information was related to the physician himself/ herself or to the practice as a whole.

Results: In total, eight PRWs were detected. Our analysis turned up 139 different information items on eight websites; 67 are related to the structural quality, 4 to process quality, 5 to outcomes, and 63 to patient satisfaction/experience. In total, 37% of all items focus specifically on the physician and 63% on the physician’s practice. In terms of the total amount of information provided on the PRWs, results range from 61 down to 13.5 items.

Conclusions: A broad range of information is available on German PRWs. While structural information can give a detailed overview of the financial, technical and human resources of a practice, other outcome measures have to be interpreted with caution. Specifically, patient satisfaction results are not risk-adjusted, and thus, are not appropriate to represent a provider’s quality of care. Consequently, neither patients nor physicians should yet use the information provided to make their final decision for or against an individual physician.

Keywords

Patient satisfaction - information dissemination - internet - physician rating website - Germany

* Supplementary material published on our website www.methods-online.com.


 

  • References

  • 1 Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, District of Columbia: National Academy Press; 2001
    PubMedGoogle Scholar
  • 2 Fung CH, Lim Y, Mattke S, Damberg C, Shekelle PG. Systematic review: the evidence that publishing patient care performance data improves quality of care. Ann Intern Med 2008; 148: 111-123.
    CrossrefPubMedGoogle Scholar
  • 3 Lagu T, Hannon NS, Rothberg MB, Lindenauer PK. Patients’ evaluations of health care providers in the era of social networking: an analysis of physician-rating websites. J Gen Intern Med 2010; 25: 942-946.
    CrossrefPubMedGoogle Scholar
  • 4 Faber M, Bosch M, Wollersheim H, Leatherman S, Grol R. Public reporting in health care: how do consumers use quality-of-care information? A systematic review. Med Care 2009; 47: 1-8.
    CrossrefPubMedGoogle Scholar
  • 5 Werner RM, Asch DA. The unintended consequences of publicly reporting quality information. Jama-J Am Med Assoc 2005; 293: 1239-1244.
    PubMedGoogle Scholar
  • 6 Colmers JM. Public Reporting and Trans-parency. 2007 Available from URL http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2007/Feb/Public%20Reporting%20and%20Transparency/Colmers_pubreportingtransparency_988%20pdf.pdf.
    PubMedGoogle Scholar
  • 7 Schneider EC, Lieberman T. Publicly disclosed information about the quality of health care: response of the US public. Qual Health Care 2001; 10: 96-103.
    CrossrefPubMedGoogle Scholar
  • 8 Fischer GC, Glaeske G, Kuhlmey A, Schrappe M, Rosenbrock R, Schriba PC. et al. Cooperation and Responsibility: Prerequisites for Target-Oriented Health Care; Advisory Council on the Assessment of Developments in the Health Care System; Report for. 2007 Available from URL http://www.svr-gesundheit.de/Gutachten/Gutacht07/KF2007-engl.pdf.
    PubMedGoogle Scholar
  • 9 Porter ME, Teisberg E. Redefining Health Care. Boston, Massachusetts: Harvard Business School Press; 2006.
    Google Scholar
  • 10 Hannan EL, Kumar D, Racz M, Siu AL, Chassin MR. New York State's Cardiac Surgery Reporting System: Four years later. Ann Thorac Surg 1994; 58: 1852-1857.
    CrossrefPubMedGoogle Scholar
  • 11 Hannan EL, Siu AL, Kumar D, Kilburn JR H, Chassin MR. The decline in coronary artery bypass graft surgery mortality in New York State: The role of surgeon volume. J Am Med Assoc 1995; 273: 209-213.
    CrossrefPubMedGoogle Scholar
  • 12 Mukamel DB, Mushlin AI. Quality of care information makes a difference: An analysis of market share and price changes after publication of the New York State Cardiac Surgery Mortality Reports. Med Care 1998; 36: 945-954.
    CrossrefPubMedGoogle Scholar
  • 13 Chassin MR. Achieving and sustaining improved quality: Lessons from New York State and cardiac surgery. Health Affair 2002; 21: 40-51.
    CrossrefPubMedGoogle Scholar
  • 14 Mukamel DB, Weimer DL, Zwanziger J, Gorthy SF, Mushlin AI. Quality report cards, selection of cardiac surgeons, and racial disparities: A study of the publication of the New York State Cardiac Surgery Reports. Inquiry-J Health Car 2005; 41: 435-446.
    PubMedGoogle Scholar
  • 15 Cutler DM, Huckman RS, Landrum MB. The role of information in medical markets: An analysis of publicly reported outcomes in cardiac surgery. Am Econ Rev 2004; 94: 342-346.
    CrossrefPubMedGoogle Scholar
  • 16 Jha AK, Epstein AM. The predictive accuracy ofthe New York State coronary artery bypass surgery report-card system. Health Affair 2006; 25: 844-855.
    CrossrefPubMedGoogle Scholar
  • 17 Dranove D, Sfekas A. Start Spreading the News: A Structural Estimate of the Effects of New York Hospital Report Cards. J Health Econ 2008; 27: 1201-1207.
    CrossrefPubMedGoogle Scholar
  • 18 Vladeck BC, Goodwin EJ, Myers LP, Sinisi M. Consumers and hospital use: The HCFA “death list”. Health Affair 1988; 7: 122-125.
    CrossrefPubMedGoogle Scholar
  • 19 Mennemeyer ST, Morrisey MA, Howard LZ. Death and reputation: How consumers acted upon HCFA mortality information. Inquiry-J Health Car 1997; 34: 117-128.
    PubMedGoogle Scholar
  • 20 Howard DH. Quality and consumer choice in healthcare: Evidence from kidney transplantation. Top Econ Anal Policy 2006; 5: 1349
    PubMedGoogle Scholar
  • 21 Howard DH, Kaplan B. Do Report Cards Influence Hospital Choice? The Case of Kidney Transplantation. Inquiry-J Health Car 2006; 43: 150-159.
    PubMedGoogle Scholar
  • 22 Romano PS, Zhou H. Do well-publicized risk-adjusted outcomes reports affect hospital volume?. Med Care 2004; 42: 367-377.
    CrossrefPubMedGoogle Scholar
  • 23 Li Z, Carlisle DM, Marcin JP, Castellanos LR, Romano PS, Young JN. et al Impact of public reporting on access to coronary artery bypass surgery: The California Outcomes Reporting Program. Ann Thorac Surg 2010; 89: 1131-1138.
    CrossrefPubMedGoogle Scholar
  • 24 Baker DW, Einstadter D, Thomas C, Husak S, Gordon NH, Cebul RD. The effect of publicly reporting hospital performance on market share and risk-adjusted mortality at high-mortality hospitals. Med Care 2003; 41: 729-740.
    PubMedGoogle Scholar
  • 25 Stevenson DG. Is a Public Reporting Approach Appropriate for Nursing Home Care?. J Health Polit Polic 2006; 31: 773-810.
    PubMedGoogle Scholar
  • 26 Hibbard JH, Stockard J, Tusler M. Hospital performance reports: Impact on quality, market share, and reputation. Health Affair 2005; 24: 1150-1160.
    PubMedGoogle Scholar
  • 27 Pope DG. Reacting to Rankings: Evidence from ‘America's Best Hospitals’. J Health Econ 2009; 28: 1154-1165.
    CrossrefPubMedGoogle Scholar
  • 28 Bundorf MK, Chun N, Goda GS, Kessler DP. Do markets respond to quality information? The case of fertility clinics. J Health Econ 2009; 28: 718-727.
    CrossrefPubMedGoogle Scholar
  • 29 Wübker A, Sauerland D, Wübker A. Beeinflussen bessere Qualitätsinformationen die Krankenhauswahl in Deutschland? Eine empirische Untersuchung. Jahrbücher für Nationalökonomie und Statistik 2010; 230: 467-490.
    PubMedGoogle Scholar
  • 30 Strech D. Arztbewertungsportale aus ethischer Perspektive. Eine orientierende Analyse. Z Evid Fortbild Qual Gesundhwes 2010; 104: 674-681.
    CrossrefPubMedGoogle Scholar
  • 31 Reimann S, Strech D. The representation of patient experience and satisfaction in physician rating sites. A criteria-based analysis of English- and German-language sites. BMC Health Serv Res 2010; 10: 332
    CrossrefPubMedGoogle Scholar
  • 32 Kofahl C, Nickel S, Trojan A. Arztsuche im Internet. In Böcken J, Braun B, Landmann J. editors. Gesundheitsmonitor. 2009. Gesundheitsversorgung und Gestaltungsoptionen aus der Perspektive der Bevölkerung. Gütersloh: Bertelsmann Stiftung; 2009.
    Google Scholar
  • 33 Given R. MD rating websites: current state of the space and future prospects; 2008. Available from URL http://thehealthcareblog.com/blog/2008/11/10/md-rating-sites-current-state-of-the-space-and-future-prospects/.
    PubMedGoogle Scholar
  • 34 Emmert M, Maryschok M, Eisenreich S, Schöffski O. Arzt-Bewertungsportale im Internet - Geeignet zur Identifikation guter Arztpraxen?. Gesundheitswesen 2009; 71: e18-e27.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 35 Donabedian A. Evaluating the quality of medical care. Milbank Meml Fund Q 1966; 44 Suppl 166-206.
    PubMedGoogle Scholar
  • 36 Donabedian A. The quality of care. How can it be assessed?. Jama-J Am Med Assoc 1988; 260: 1743-1748.
    PubMedGoogle Scholar
  • 37 Fox S. Online health search 2006 [PEW internet & American life project]. Washington D.C.: 2006 Available from URL http://www.pewinternet.org/~/media//Files/Reports/2006/PIP_Online_Health_2006.pdf.pdf.
    PubMedGoogle Scholar
  • 38 Stvilia B, Mon L, Yi YJ. A model for online consumer health information quality. J Am Soc Inf Sci Tec 2009; 9: 1781-1791.
    PubMedGoogle Scholar
  • 39 Webhits Internet Design GmbH. Web-Barometer. 2010 Available from URL http://www.webhits.de/deutsch/index.shtml?webstats.html.
    PubMedGoogle Scholar
  • 40 Spink A, Jansen BJ, Wolfram D, Saracevic T. From E-Sex to E-Commerce: Web Search Changes. Computer 2002; 35: 107-109.
    CrossrefPubMedGoogle Scholar
  • 41 Campbell SM, Roland MO, Buetow SA. Defining quality of care. Soc Sci Med 2000; 51: 1611-1625.
    CrossrefPubMedGoogle Scholar
  • 42 Roeg D, van de GoorI, Garretsen H. Towards quality indicators for assertive outreach programmes for severely impaired substance abusers: concept mapping with Dutch experts. Int J Qual Health C 2005; 17: 203-208.
    CrossrefPubMedGoogle Scholar
  • 43 Badelt C. Soziale Dienstleistungen und der Umbau des Sozialstaates. In Hauser R. editor. Reform des Sozialstaates 1. Berlin: Duncker & Humblot; 1997.
    Google Scholar
  • 44 van Driel ML, Sutter I an de, Christiaens TCM, Maeseneer JM de. Quality of care: the need for medical, contextual and policy evidence in primary care. J Eval Clin Pract 2005; 11: 417-429.
    CrossrefPubMedGoogle Scholar
  • 45 Sorian R. Measuring, reporting, and rewarding performance in health care. 2006 Available from URL http://www.commonwealthfund.org/usr_doc/Sorian_measuringreporting_912.pdf?section=4039.
    PubMedGoogle Scholar
  • 46 Dahmen KG, Albrecht DM. An approach to quality management in anaesthesia: a focus on perioperative care and outcome. Eur J Anaesth Suppl 2001; 23: 4-9.
    PubMedGoogle Scholar
  • 47 Hays RB, Veitch C, Evans RJ. The determinants of quality in procedural rural medical care. Rural Remote Health 2005; 5: 473
    PubMedGoogle Scholar
  • 48 Liebel DV, Friedman B, Watson NM, Powers BA. Review of nurse home visiting interventions for community-dwelling older persons with existing disability. Med Care Res Rev 2009; 66: 119-146.
    CrossrefPubMedGoogle Scholar
  • 49 Simon A. Der Informationsbedarf von Patienten hinsichtlich der Krankenhausqualität: Eine empirische Untersuchung zur Messung des Involvements und der Informationspräferenzen. Wiesbaden: Gabler; 2010.
    Google Scholar
  • 50 Mostaghimi A, Crotty BH, Landon BE. The availability and nature of physician information on the internet. J Gen Intern Med 2010; 25: 1152-1156.
    CrossrefPubMedGoogle Scholar
  • 51 Kolkmann F, Seyfarth-Metzger I, Stobrawa F. Leitfaden: Qualitätsmanagement im deutschen Krankenhaus. München: Zuckschwerdt; 2001.
    Google Scholar
  • 52 Umpierre D, Ribeiro PAB, Kramer CK, Leitão CB, Zucatti ATN, Azevedo MJ. et al Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. Jama-J Am Med Assoc 2011; 305: 1790-1799.
    PubMedGoogle Scholar
  • 53 Rosen AK, Reid R, Broemeling A, Rakovski CC. Applying a risk-adjustment framework to primary care: can we improve on existing measures?. Ann Fam Med 2003; 1: 44-51.
    CrossrefPubMedGoogle Scholar
  • 54 Emmert M, Sander U, Maryschok M, Esslinger AS, Schöffski O. Arzt-Bewertungsportale im Inter-net: Eine aktuelle Bestandsaufnahme. IMPLICONplus - Gesundheitspolitische Analysen 2010: 9
    PubMedGoogle Scholar
  • 55 Kassenärztliche Bundesvereinigung. Grunddaten zur vertragsärztlichen Versorgung in Deutschland. 2010 2010. Available from URL http://daris.kbv.de/daris/link.asp?ID=1003761630.
    PubMedGoogle Scholar
  • 56 Scholle SH, Roski J, Adams JL, Dunn DL, Kerr EA, Dugan DP. et al Benchmarking physician performance: reliability of individual and composite measures. Am J Manag C 2008; 14: 833-838.
    PubMedGoogle Scholar
  • 57 Simon A. Patienteninvolvement und Informationspräferenzen zur Krankenhausqualität. Unfallchirurg 2011; 114: 73-78.
    CrossrefPubMedGoogle Scholar
  • 58 Schaefer C, Schwarz S. Wer findet die besten Ärzte Deutschlands?: Arztbewertungsportale im Internet. Z Evid Fortbild Qual Gesundhwes 2010; 104: 572-577.
    CrossrefPubMedGoogle Scholar
  • 59 Birkmann C, Dumitru RC, Prokosch HU. Evaluation of health-related internet use in Germany. Method Inform Med 2006; 45: 367-376.
    PubMedGoogle Scholar