Global Health Policy and Access to Care: Investigating Patient Choice on an International Level Using Social Media

Abstract

BackgroundIncreased access to transportation and information has led to the emergence of more diverse patient choice and new forms of health care consumption, such as medical travel. In order for health care providers to effectively attract patients, more knowledge is needed on the mechanisms underlying decision-making of potential travelers from different countries. A particularly promising method of studying the travelers’ motives is collecting data on social media.ObjectivesThe aim of this study was to test what factors influence decision-making of potential medical travelers and how these factors interact. Based on existing literature, the factors analyzed included quality, cost, and waiting time for 2 procedures varying in invasiveness across 12 different destination countries.MethodsDecision-making patterns were examined using a pilot questionnaire that generated a large amount of data from over 800 participants in 40 countries. Participants indicated their willingness to travel given different scenarios. Each scenario consisted of a combination of several factors. Additionally, participants were asked to indicate the reasons for their choice.ResultsIndividuals display high willingness to travel for medical care when combining all participants and scenarios, travel for care was chosen 66.9% of the time. Among the factors influencing their decisions, quality of the medical procedure abroad was considered most important, and cost was least important as shown by chi-square tests and corresponding odds ratios. Log-linear analyses revealed an interaction between time waiting in the local health care system and type of procedure, whereby time pressure increased the odds of agreeing to travel for the more invasive procedure. The odds of traveling to Europe and the USA were by far the highest, although participants indicated that under certain conditions they might be willing to travel to other medical destinations, such as Asia.ConclusionOur measurements yielded several reliable insights into the factors driving medical decision-making. An essential next step would be to expand these findings with a more encompassing sample and more elaborate statistical modeling.

An evidence-based policy for improving choice in global health access through medical travel

“…individuals to travel for medical purposes and include quality of care, costs, and waiting time or the type of medical procedure under consideration [14]. While there have been attempts to model these factors using frameworks for a range of relevant drivers [6], significant interactions between those factors were left unexplored.…”

“…Considering the evidence available in light of the patterns of behavior as well as challenges presented, a multi-year study covering multiple key aspects of medical travel was carried out by a large team of researchers from a number of countries (predominantly from Europe and North America) [1,9,10,11,12,14,16,17]. The largest of these studies involved a sophisticated decision-making instrument for assessing likelihood of travel that would have the potential to inform policy through validating the strongest predictions of behavior.…”

“…The sample was predominantly European (87.7%) and 74.5% had at least a bachelor-level degree (or equivalent) or above. Sample characteristics are further detailed in a previous publication [14], though some participants considered in prior analyses were excluded in this particular model. Participants gave explicit informed consent prior to their participation.…”

“…To identify the main drivers of medical travel, a novel instrument based upon different combination of three domains was developed [14]. The domains were 1) invasiveness of procedure (i.e., hip and heart valve replacement); 2) reason for travel (i.e., fewer costs, shorter waiting lists, better quality of care); and 3) country of destination for a proposed medical procedure (namely Australia, Dubai, Germany, United Kingdom, Malta, New Zealand, Philippines, Portugal, Qatar, Singapore, Thailand and the United States of America).…”

“…characteristics (i.e., sex, age, education level and income level); previous experience with medical travelling; time spent living abroad, and perception of local healthcare (i.e., own healthcare quality, cost and waiting times). These domains were selected according to literature reviews [1,14].…”