Abstract
BACKGROUND: The free choice of hospital by patients is promoted by health policy and is to be supported by the quality reports of hospitals. But how do patients choose a hospital? How many can decide for themselves, where do they inform themselves and what are their decision criteria in the specific situation? This will be answered for inpatients of internal medicine in comparison to those of other specialties. METHODS: The data originate from an observational study. The random sample, stratified by specialties and hospital care levels, was collected in 46 departments of 17 hospitals from 15 cities and municipalities in North Rhine-Westphalia. The weighted sample evaluates 758 patients of internal medicine and 1168 patients of other specialties descriptively and inferentially. RESULTS: Internal medicine patients are older, more often men, without a migration background and chronically ill, and also more often pretreated as inpatients. About half decide on the hospital themselves, with their own knowledge of the hospital through a previous stay being the most important source of information and the important decision criteria being their own previous experience, the hospital call and the recommendation of outpatient treatment providers. The small proportion of patients with more time before admission choose more actively. CONCLUSIONS: In internal medicine, fewer patients can decide on the hospital themselves. These then decide quite predominantly on the basis of their previous experience with the hospital and continue the renewed treatment in the hospital with which they are also familiar. A small proportion of younger, more educated and less hospital-experienced patients inform themselves more actively before elective procedures. Patients' treatment experiences are central to their own and their relatives' choice of hospital via social exchange.