OBJECTIVE: To determine how the general public interprets surgical complication rates presented from a publicly available online surgical-rating website.
SUBJECTS AND METHODS: An in-person electronic survey was administered at the local State Fair to a convenience sample. Participants were presented with a representative output from an online surgeon-rating website and were asked to choose from three statistically equivalent surgeons for a hypothetical medical decision. We then suggested that their insurance company would only cover one surgeon and probed their willingness to pay to switch surgeons for a small chance of lowering the risk of a complication (0.7%, 95% confidence interval [CI] -8.1% to 9.5%, P = 0.9). We quantified the characteristics of those willing to switch, the degree of misinterpretation, and the subsequent potential patient harms.
RESULTS: There were 343 completed responses. When presented with a hypothetical healthcare decision, most participants (n = 209, 61%) said they were willing to pay out-of-pocket expenses to switch to a statistically equivalent surgeon. Those who were willing to pay to switch surgeons were more likely to be older (odds ratio [OR] 1.02, 95% CI 1.01-1.03), poorer (OR 1.81, 95% CI 1.07-3.11), previously had cancer (OR 5.9, 95% CI 1.9-25), and misinterpreted the data (OR 3.03, 95% CI 1.87-4.96). Those who were willing to pay out-of-pocket expenses were more inaccurate in their estimation of surgeon complication rates (mean estimate 34.0% vs 8.9%, P < 0.001, correct rate = 3.6%), and on average were willing to pay $6 494 (95% CI 4 108-8 880).
CONCLUSION: Understanding of a publicly reported surgical-complication website is often prone to misinterpretation by the general population and may lead to patient harm from a financial aspect.
Bibliographical noteFunding Information:
Badrinath R. Konety has relationships with Genomic Health, Roche/Genentech, Photocure MDx Health, Bristol Myers Squibb, Pacific Edge Diagnostics, NxThera, Journal of Urology, Urologic Oncology and has received grant funding from National Institutes of Health and Depatment of Defense.
© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd
- data interpretation
- health literacy
- information literacy
- outcomes research
- postoperative complications
- Decision Making
- Economic Status
- Age Factors
- Risk Assessment
- Middle Aged
- Postoperative Complications/etiology
- Health Expenditures
- Insurance Coverage
- Patient Harm
- Surgical Procedures, Operative/adverse effects
- Surveys and Questionnaires
- Insurance, Health
PubMed: MeSH publication types
- Journal Article