Published in:
01-11-2014 | Healthcare Policy and Outcomes
Choosing a Cancer Surgeon: Analyzing Factors in Patient Decision Making Using a Best–Worst Scaling Methodology
Authors:
Aslam Ejaz, MD, MPH, Gaya Spolverato, MD, John F. Bridges, PhD, Neda Amini, Yuhree Kim, MD, MPH, Timothy M. Pawlik, MD, MPH, PhD
Published in:
Annals of Surgical Oncology
|
Issue 12/2014
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Abstract
Background
Surgeon experience has been shown to influence outcomes for many types of cancer. The factors that patients consider when selecting a hospital or surgeon for cancer treatment remain poorly defined.
Methods
All patients with a cancer diagnosis seeking treatment at a surgical clinic at Johns Hopkins Hospital were asked to participate. A survey utilizing a best–worst scaling methodology was constructed to elicit the importance of various factors when selecting a cancer surgeon. Attributes were grouped into four categories: surgeon reputation, surgeon qualifications, hospital-related factors, and nonclinical factors.
Results
Two hundred fourteen patients with a cancer diagnosis participated in the study (82.0 % response rate). Patients placed the highest value on physician qualifications and hospital-related factors. Specifically, surgeon case-specific experience (coefficient 2.56, SE 0.06) and the receipt of specialized training by the surgeon (coefficient 2.32, SE 0.06) ranked highest (both P < 0.001). Among hospital-related factors, hospital case-specific volume (coefficient 1.32, SE 0.06; P < 0.001) was most important. The lowest rated factors were parking availability (coefficient −2.81, SE 0.06) and home-to-clinic distance (coefficient −2.12, SE 0.06) (both P < 0.001). The majority of patients reported their ideal surgeon to have at least 6 years of experience (n = 143, 68.1 %) and to have performed their specific procedure at least 50 times (n = 156, 75.3 %).
Conclusions
Patients consider several factors when choosing a cancer surgeon. Surgeon qualifications and hospital-related factors appear to be most influential in their decision. Easier and more widespread dissemination of surgeon and hospital cancer data such as case volume may be useful for patients.