RAND: patient preferences should inform hospital rankings

RAND Corporation researchers have effectively endorsed key elements of the Value Ratings method for hospital rankings.

The article appears in the New England Journal of Medicine. The authors call for tailoring summary performance ratings by incorporating the preferences and needs of individual users.

Followers of this blog will recognize this counsel as being in near perfect accord with Value Ratings.

Hospital rankings: how RAND aligns with Value Ratings

The similarity between what the RAND researchers write and our Value Ratings methodology is remarkable and significant. Some article excerpts:

  • A report tailored to the “average patient” will probably be a poor fit for most.
  • [As] currently constructed, the weighting systems that underlie overall hospital performance ratings are expressions of the values, preferences, and tastes of their creators.
  • One-size-fits-all weighting…can be replaced with user-determined weights in the Internet age.
  • By allowing such personalization, creators of performance reports can enhance the value of their overall ratings and rankings to the consumers who might use them.

Next, the RAND researchers demonstrate how hospital rankings would change for two fictitious people, Patient A and Patient B. This closely parallels our fictional Alice and Bob, who rate medical groups differently using real performance data produced by the Washington Health Alliance.

The researchers imagine a scheme where a user assigns weights to performance domains in isolation from each other. We have noted this procedure as being prone to introspection risk. The authors also appear to recognize this pitfall. They suggest suitable weights might someday be “based on the results of a questionnaire.” Here, we see a clear parallel to the survey that reveals your Preference Profile. It detects and quantifies both the priority and relative importance of your preferences across multiple areas of performance. Most importantly, this includes untangling the interplay between areas.

Better options for people seeking healthcare

RAND’s counsel could be good news for healthcare consumers. Soon, the decision aids made available to patients might acknowledge their situational needs and personal values.