Factors influencing medical institution selection for outpatient services

Abstract

T his study analyzes determinants of patients' choice of healthcare providers in outpatient services and identifies their effects. Data were collected from two waves of the Korean Health Panel. The unit of analysis was an outpatient visit (n=189,739). Various types of medical institutions were grouped into general hospitals (including tertiary hospitals), hospitals, and clinics. A multinomial logit model was used to examine the determinants of medical institution selection. Clinics were the most frequent (82.2%) medical institution selected, followed by general hospitals (10.9%) and hospitals (6.9%). Males and beneficiaries of Medical Aid were more likely to choose the upper-level institutions. The upper-level institution selection was also positively associated with the level of education, household income, and severe diseases, while negatively associated with the level of health status. The medical institution selection was significantly different by region. Not only enabling factors for healthcare utilization, such as family and community resources, but also the users' characteristics were strong determinants of the type of medical institution selected. We, therefore, recommend that patients' characteristics and needs, in addition to the sharing of roles and functions among medical institutions, should be considered in making healthcare policies for efficient medical utilization and an effective medical delivery system.

Effect of providing drug utilization review information on tricyclic antidepressant prescription in the elderly

“…The predicted relative change rate also decreased more in patients receiving TCAs with a CCI of 0 and in patients from rural areas and clinics, which means that TCA prescription decreased more than that in the other groups, despite considering the fact that the higher the frequency of TCA prescription, the more it decreases. Patients with a severe disease usually choose high-end hospitals in larger cities [ 26 , 27 ], whereas those with a mild disease tend to be treated more in rural areas and clinics. Medication changes are relatively easy for low-risk patients because of a wide range of drug choices.…”

Factors that Affect the Adherence to ADHD Medications during a Treatment Continuation Period in Children and Adolescents: A Nationwide Retrospective Cohort Study Using Korean Health Insurance Data from 2007 to 2011

“…There may be several reasons for this result. According to a recent report in Korea, 38 the factors that were associated with the upper-level institutions are males, beneficiaries of Medical Aid, education level, household income, and severe diseases; the last three factors were negatively associated with the level of health status. Thus, we speculated that our results were favorable for the private clinic regarding adherence because of the following factors: there are differences in the utilization patterns for a private clinic compared with a general hospital regarding the availability of the out-patient department clinic schedule for unexpected schedule changes or extra sessions, the type of additional psychosocial programs in the clinic are different, and the severity of the disease is different; however, these factors were not directly assessed in the current study” if the edit maintains the intended meaning.…”

Sex Differences in Factors Affecting Hospital Outpatient Department Visits: Korea Health Panel Survey Data from 2009 to 2016

“…In South Korea, health care users can freely choose health care institutions regardless of its type for outpatient visits, and economic factors (since treatment at hospitals is more expensive), distance, and time affect selection of health care institution [43][44][45][46]. Andersen's health care utilization model considers these as enabling factors.…”