Asset sharing in healthcare sectors: part two—an examination of unintended patient outcomes

Background/Aims Asset sharing is becoming increasingly common in the healthcare sector. However, its specific applications to the healthcare sector and the potential unintended consequences have not received adequate research attention. This is the second study in a two-part research effort looking at the unintended consequences of asset sharing, particularly when the decision to share assets is made by the healthcare service provider, rather than the service user. This study aimed to assess the potential mediating role of patients' perceptions of contamination in shared healthcare assets on patient satisfaction with the physician and the treatment decision, intention to use the service again and willingness to recommend the service to others. Methods This was an experimental study with 261 participants, recruited from the general population via an online crowdsourcing platform and randomly assigned to one of three conditions. All participants read a vignette scenario in which a physician recommends surgery for knee problems. In the non-sharing condition, the physician explains that the operating room is used by their practice only. In the two sharing conditions, the physician explains that the room is used by five or 10 other practices. After reading the scenarios, participants' perceived contamination was measured using a seven-item semantic scale tool. Participants' satisfaction with the physician and their treatment decision, intention to use the service again and willingness to recommend the service to others were measured using 7-point Likert scales. The SPSS macro PROCESS model 4 with Helmert coding was used to analyse the data. Results There was a positive association between perceived contamination and sharing with both five other practices (b=0.40; P=0.01) and 10 other practices (b=0.42; P=0.02) among participants. There were negative associations between perceived contamination and predictions of satisfaction with the physician (b=-0.30; P=0.00), satisfaction with the physician's treatment decision (b=-0.30; P=0.00), intention to use the physician's service again (b=-0.34; P=0.00) and willingness to recommend the service to others (b=-0.36; P=0.00). Conclusions This study indicates that perceived contamination is a key factor to consider when exploring and addressing the unintended effects of asset sharing in healthcare. Healthcare organisations should consider strategies to reassure patients and reduce the impact of perceived contamination on patients' perceptions of services that use shared assets.