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The importance of experienced adverse outcomes on patients' future choice of a hospital for surgery
  1. P J Marang-van de Mheen1,
  2. J Dijs-Elsinga1,
  3. W Otten1,
  4. M Versluijs2,
  5. H J Smeets3,
  6. W J van der Made4,
  7. R Vree5,
  8. J Kievit1,4
  1. 1Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
  2. 2Federation of Patients and Consumer Organisations in the Netherlands (NPCF), Utrecht, The Netherlands
  3. 3Department of Surgery, Bronovo Hospital, The Hague, The Netherlands
  4. 4Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
  5. 5Department of Surgery, Diaconessenhuis Leiden, Leiden, The Netherlands
  1. Correspondence to Dr P J Marang-van de Mheen, Department of Medical Decision Making, Leiden University Medical Center, J10-S, PO Box 9600, Leiden 2300 RC, The Netherlands; p.j.marang{at}


Objective To assess whether patients who experience adverse outcomes during hospitalisation or after discharge differ in the information they would use for future choices of a hospital for surgery compared with patients without any adverse outcomes.

Design Cross-sectional questionnaire study, including questions on (1) adverse outcome occurrence during hospitalisation and after discharge, (2) information patients would use for future hospital choice and (3) priority of information.

Setting Three hospitals in the western part of The Netherlands.

Study sample All 2122 patients who underwent elective aorta reconstruction (for treatment of aneurysm), cholecystectomy, colon resection, inguinal hernia repair, oesophageal resection or thyroid surgery in the period 2005–2006, of whom 1329 (62.6%) responded.

Results Patients who experienced postdischarge adverse outcomes intend to use more information items to choose a future hospital (on average 1.6 items more). They more often would use the item on information provision during hospitalisation (OR 2.35 (1.37 to 4.03)) and information on various quality-of-care measures, compared with patients without adverse outcomes. Patients who experienced in-hospital adverse outcomes would not use more information items but more often would use the item on mortality after surgery (OR 1.93 (1.27 to 2.94)) and extended hospital stay (OR 1.61 (1.10 to 2.36)). However, when asked for priority of information, previous treatment in that hospital is mentioned as the most important item by most patients (32%), regardless of adverse outcome occurrence, followed by hospital reputation and waiting time.

Conclusions Adverse outcome experience may change the information patients use (on quality of care) to choose a future hospital.

  • Quality of care
  • surgery
  • adverse outcomes
  • decision-making
  • patient outcomes
  • adverse event

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  • Funding Netherlands Organisation for Health Research and Development, Program Choice in Health Care (grant number 32570101). PO Box 93245, 2509 AE The Hague, The Netherlands.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Leiden University Medical Centre.

  • Provenance and peer review Not commissioned; externally peer reviewed.