Choosing a high-quality hospital: the role of nudges, scorecard design and information

Abstract

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