Presenting Cost and Efficiency Measures That Support Consumers to Make High-Value Health Care Choices

Health Serv Res. 2018 Aug;53 Suppl 1(Suppl Suppl 1):2662-2681. doi: 10.1111/1475-6773.12839. Epub 2018 Feb 25.


Objective: To identify approaches to presenting cost and resource use measures that support consumers in selecting high-value hospitals.

Data sources: Survey data were collected from U.S. employees of Analog Devices (n = 420).

Study design: In two online experiments, participants viewed comparative data on four hospitals. In one experiment, participants were randomized to view one of five versions of the same comparative cost data, and in the other experiment they viewed different versions of the same readmissions data. Bivariate and multivariate analyses examined whether presentation approach was related to selecting the high-value hospital.

Principal findings: Consumers were approximately 16 percentage points more likely to select a high-value hospital when cost data were presented using actual dollar amounts or using the word "affordable" to describe low-cost hospitals, compared to when the Hospital Compare spending ratio was used. Consumers were 33 points more likely to select the highest performing hospital when readmission performance was shown using word icons rather than percentages.

Conclusions: Presenting cost and resource use measures effectively to consumers is challenging. This study suggests using actual dollar amounts for cost, but presenting performance on readmissions using evaluative symbols.

Keywords: Quality improvement/report cards; health care costs; medical decision-making.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Choice Behavior*
  • Decision Making
  • Efficiency, Organizational*
  • Female
  • Health Expenditures / statistics & numerical data*
  • Hospital Administration / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data
  • Quality Indicators, Health Care
  • Quality of Health Care / organization & administration*
  • Quality of Health Care / standards
  • United States