Patients' experience of choosing an outpatient clinic in one county in Denmark: results of a patient survey

Abstract

BackgroundResearch on patients' choice of hospital has focused on inpatients' rather than outpatients' choice of provider. We have investigated Danish outpatients' awareness and utilisation of freedom of choice of provider; which factors influence outpatients' choice of hospital, and how socio-demographic variables influence these factors in a single uptake area, where patients were free to choose any public hospital, where care was provided free at the point of delivery, and where distance to the closest hospitals were short by international standards.MethodsRetrospective questionnaire study of 4,232 outpatients referred to examination, treatment, or follow-up at one of nine somatic outpatient clinics in Roskilde County in two months of 2002, who had not been hospitalised within the latest 12 months. The patients were asked, whether they were aware of and utilised freedom of choice of hospital.ResultsFifty-four percent (2,272 patients) filled in and returned the questionnaire. Forty-one percent of respondents were aware of their right to choose, and 53% of those patients utilised their right to choose. Awareness of freedom of choice of provider was reported to be especially high in female outpatients, patients with longer education, salaried employees in the public sector, and in patients referred to surgical specialties. Female outpatients and students were especially likely to report that they utilised their right to choose the provider. Short distance was the most important reason for outpatients' choice, followed by the GP's recommendations, short waiting time, and the patient's previous experience with the hospital.ConclusionsOutpatients' awareness and utilisation of free choice of health care provider was low. Awareness of freedom of choice of provider differed significantly by specialty and patient's gender, education and employment. Female patients and students were especially likely to choose the clinic by themselves. Most outpatients chose the clinic closest to their home, the GP's recommendation and short waiting time being the second and third most important factors behind choice.

Patients' and clinicians' views of comparing the performance of providers of surgery: a qualitative study

“…Perhaps the most important finding from the point of view of future health-care policy is the relative importance or influence that factors other than providers' outcomes have on patients' choice. This is consistent with recent quantitative studies from Denmark and the Netherlands, which also found the factors influencing patients were shorter waiting times [29][30][31] ; shorter distance to the hospital 29,30.32 ; the views of GPs 30 and patients' previous experience of the facility. [29][30][31] Two studies in England have reported the influence of distance 33 and the reputation of the provider.…”

“…This is consistent with recent quantitative studies from Denmark and the Netherlands, which also found the factors influencing patients were shorter waiting times [29][30][31] ; shorter distance to the hospital 29,30.32 ; the views of GPs 30 and patients' previous experience of the facility. [29][30][31] Two studies in England have reported the influence of distance 33 and the reputation of the provider. 18 This growing body of literature lends weight to the rather limited impact that provider performance data might be expected to have on patient choice.…”

Effect of distance to health facility on the maintenance of INR therapeutic ranges in rheumatic heart disease patients from Cape Town: no evidence for an association

“…Patients attending Groote Schuur Hospital (GSH), the only tertiary hospital included among the INR clinics, travelled a median distance of 18.2 km (1.6 km–50.8 km), which was noticeably further than the median road distance of 3.60 km travelled by patients overall to treatment facilities. Reasons for this may include a possible perception of higher quality care or convenience associated with GSH, if located near to a place of employment [ 22 ]. The overall proportion of patients within the target INR therapeutic range was 50.3 %.…”

The Political Role of Corporate Citizens

“…In specialist and hospital care, there are as of yet no studies conducted in Sweden on how patient choice rights are used (which are weaker in this sector since they are not legally sanctioned) by different groups. Studies from other Nordic countries as well as the UK indicate, however, that the better-educated use this right more actively than those with lower education (Ringard, 2012;Birk et al, 2011;Dixon et al, 2010).…”