Health Service Quality Information Comparison: A Preliminary Investigation

Health Service Quality Information Comparison: A Preliminary Investigation

Yun Wan (University of Houston, USA) and Susan Evans-Mueller (HCA Shared Services Group, USA)
DOI: 10.4018/978-1-61520-733-6.ch008
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This chapter investigates the provision of public health information, especially health service quality and cost information, to the general public in the United States. The authors first review the health system of the US from three aspects: its public policy, structure, and accreditation of health institutions. Then the complexity of health information provision and the challenges in its interpretation are identified and analyzed. “Comparison-shopping” is introduced as a new mode of decision support for individuals to select health services, and examples of its current applications are given. The comparison-shopping mechanism in the e-commerce industry and the health information industry are compared and the different driving forces in health information comparison-shopping are analyzed. Several directions for future research are provided for researchers and health practitioners.
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Health service information includes service provider information, service cost information, and service quality information. They are three integral parts of quality health care for consumers. Service provider information allows consumers to find the health service they need. Service cost information provides consumers with the price of different care and allows consumers to compare and select commensurate support for their health needs. Finally, service quality information allows consumers to compare and pick the quality health services and providers from an otherwise seemingly identical set of them, thus making informed decisions.

With the popularity of the Web, there is increasingly easy access to service provider information and insurance information by the general public, however, most health service quality information is not accessible or easily accessed by the public. Thus in this chapter, we will focus on a discussion of health service quality information.

Service quality information such as the service ratings of hospitals, doctors, dentists, and other specialists is critical for the general welfare of the society, because it makes it easier for patients to evaluate and compare different providers and make informed decisions. Though in the United States there are many efforts being spent by the government and independent organizations on improving the quality and accessibility of such information, the effective and efficient use of such information by the general public is not receiving equal attention. American society is a highly mobile society and people relocate frequently, thus there is a constant need for individuals and families to find new health services. Efficient and effective access to health service quality information would not only improve the quality of health services offered by service providers due to the pressure of comparisons among providers, but also bring benefit to consumers. The outcome is an overall increase in the quality of health services.

Recently, the “comparison-shopping” model has emerged as an innovative way to increase the efficacy of health service information provision especially quality information. Though still in its nascent stage of development, now a consumer could conduct comparison-shopping on health service information ranging from selection of health insurance provider, hospitals, or physicians, to prescription drugs. These services are still in a very primitive stage compared with a commodity comparison-shopping market such as But with a simple comparison list of service ratings of local dentists, for instance, a couple moved-in to a new neighborhood, could choose a quality dentist instead of taking a random chance.

This new way of obtaining health services information has important social consequences. If such a practice is widely used, it will increase service quality of health providers through competition. It could also reduce the cost of health care in general because cost is one aspect of comparison attributes valued by consumers. Take the example of insurance, Brown and Goolsbee (2002) provided empirical evidence on how Internet comparison shopping sites affected the price of life insurance in the 1990s. They found that growth of the Internet and comparison-shopping sites have reduced term life insurance cost by 8 to 15 per cent and increased consumer surpluses by $115 to $215 million per year and perhaps more. Though term life insurance is a relatively simple insurance compared with health insurance, we can reasonably expect that consumers will be able to compare health insurance and health insurance providers and coverage more effectively with more advanced decision support technology and get comparable benefits as those seen with term life insurance.

Currently, comparison-shopping on health-related information is provided by various entities, such as commercial enterprises, non-profit organizations, and government agencies. An analysis of this topic needs to address the complex structures of the U.S. health system. This complexity makes the underlying mechanisms of comparison-shopping in the health industry significantly different from its counterpart in the electronic commerce market. For instance, in the healthcare industry, public policy rules, while in the e-commerce industry, the invisible hand of the market rules.

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