Awarding and performance monitors: Do hospitals care?

Introduction Since the Dutch health care reforms in 2006, patients are expected to choose between healthcare providers. Several patient organizations developed projects to offer choice support to their members and to incentivize quality improvement by health care providers. The quality improving effects of these projects is dependent on the response of the providers. This research investigates the different effects of five of these projects on health care quality improving actions. Methodology The research was conducted by examining the quality improving and choice supporting projects of five patient organizations: The plume for fertility care, the ribbon for breast cancer care, the cardiovascular hallmark, the rheumatism monitor and the project ‘quality of integrated care’. A questionnaire was sent out to the contacts of these projects about their motivation to participate in the project and the changes they made due to the criteria of the project. Results 202 questionnaires about the five projects were completed. The response rate was 40.8%. Participants of the ribbon appeared to have made most changes as a consequence of the criteria. The change that was made most by participants of the ribbon was an improved digital registration. For the other projects the most often made change was adjusted information provision towards patients. No difference in response to the projects appeared between hospitals in areas with high and low competitive pressure. The attitude of health care providers towards awarding appeared to be less positive for hospitals that received an award than for hospitals that did not. Conclusion and discussion All projects appeared to have a quality improving influence on the hospitals. The effect of the ribbon is largest, which is probably due to a combination of the amount of media attention this project gets and the composition of the criteria. Patient organizations setting up an awarding project or performance monitor should keep their goals in mind and be aware of the possible motivations hospitals have for participating.