Date of Award

6-2017

Document Type

Open Access

Degree Name

Bachelor of Arts

Department

Sociology

First Advisor

Melinda Goldner

Language

English

Keywords

healthcare facilities, healthcare reform

Abstract

The U.S. healthcare system consistently underperforms on crucial international comparisons, thereby highlighting the need for reform. Simultaneously, there exists bipartisan and strong cultural support for patient choice; i.e. the ability of patients to assess the quality of healthcare facilities and choose amongst competing options. However, prior literature suggests that patients struggle to choose amongst competing facilities due to perceived competency barriers and insufficient information. In this two-phased thesis project, I abstracted a model for mobilizing patient choice as a tool for healthcare reform by designing a website which presents government data on healthcare facility performance. First, three types of focus groups were conducted to: (1) establish a patient-centric definition of quality, (2) determine the appropriate level of data granularity for a facility rating website, and (3) design a user interface for online healthcare content that takes into account patient preferences. In total, 23 subjects were recruited and split amongst the three focus groups. From the first group, a set of guidelines were extracted for a patient-centric definition of quality. Patients preferred Outcomes domains over Process or Input measures, valued Effectiveness and Safety most heavily, and had preferences that varied primarily along the lines of illness severity and length of care period. Focus Group Two illustrated the need to maintain data transparency; i.e. patients valued data on a facility’s overall performance, performance in key areas (domains), and performance on individual indicators. Lastly, Group Three set guidelines on coloration and methods to efficiently disseminate data on performance. In phase two, the focus group findings were used to guide the development of a ranking of U.S. hospitals using data included in the Centers for Medicare and Medicaid Services (CMS) database. A website design was then wire-framed using the prototyping program Axure. A post-hoc analysis revealed trends in hospital performance according to geographic location and ownership type. This line of work exerts pressure on healthcare facilities to meet a certain standard of care. Data transparency continues to serve as a viable avenue for patient empowerment and a useful lever for healthcare reform.

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