What factors determine the intention to use hospital report cards? The perspectives of users and non-users.

OBJECTIVE: Hospitals report cards (HRC) are publicly available Internet websites that provide patients with quality-related information on hospitals and enable hospital comparisons. We aim to identify factors that explain the (intended) use of HRC, including differences between current users and non-users.

METHODS: Drawing on UTAUT (Unified Theory of Acceptance and Use of Technology), a cross-sectional study was conducted. Data were derived from an online survey with 1350 respondents and analyzed using structural equation modeling.

RESULTS: 42% of the survey participants had already used HRC to search for a hospital. Performance expectancy, facilitating conditions, and attitude were found to be significantly related to HRC use intention, with notable differences between users and non-users. Effort expectancy and social influence did not show any significant effects in both subsamples.

CONCLUSION: Patients consider HRC to be a useful instrument and are willing to make the efforts it takes to use HRC. The greater effect of performance expectancy in the non-user sample (compared to the user sample) indicates a certain disillusion among users.

PRACTICE IMPLICATIONS: Health policy makers should focus on reviewing and restructuring the information content of HRC. In addition, coordinated efforts are still required to facilitate HRC access, especially for the 'less fortunate'.