市民选择公立医院还是私立医院的决定因素。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research Pub Date : 2024-11-01 DOI:10.1016/j.jhqr.2024.09.001

S. Parrado , J. Rama , A.-M. Reynaers

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引用次数: 0

摘要

研究目的本研究根据疾病的严重程度，评估哪些因素决定了公民对公立或私立医院（假设选择免费）的偏好：对 1777 人进行了一项基于网络的离散选择实验，区分对照组（对每种健康状况提出一个简单的选择）和治疗组受访者的附加信息（距离、等待时间、家庭医生的建议和社会背景的推荐）。研究调查了这些因素与个人疾病严重程度的相关性。结果变量是在治疗不同严重程度的健康问题时选择公立医院还是私立医院：结果：健康问题的严重程度对治疗组的额外信息有调节作用。无论是严重健康问题还是非严重健康问题，候诊时间对患者选择私立医院都有直接的积极影响。距离医院的远近和家庭医生的推荐对非严重健康问题患者选择私立医院有积极影响，但对严重健康问题患者选择私立医院没有积极影响。性别和年龄等协变因素与解释治疗效果无关，而教育水平对其中一种治疗方法有积极影响：来自患者环境的建议。对公立医院的满意度对所有治疗方法都有积极影响：结果表明，与大多数人对公立医院的偏好相比，等候时间是选择私立医院的关键因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Determinants of citizens’ choice between public and private hospitals

Objective

This study assesses what factors determine citizens’ preferences for a public or private hospital (assuming the choice is free of charge) according to the severity of the disease.

Material and method

A web-based discrete choice experiment was carried out with 1777 individuals distinguishing between a control group (posed with a simple choice for each health condition) and added information for respondents of the treatment groups (distance, waiting time, advice from the family doctor, and recommendations from the social context). The relevance of these factors in relation to the severity of one's illness is investigated. The outcome variable is the choice of a public versus a private hospital for the treatment of a health issue of a different severity.

Results

The severity of the health issue has a moderator effect on the additional information for the treatment groups. Waiting time has a direct positive impact on the patient's preferred choice for a private hospital both for severe and non-severe health issues. Distance to the hospital and the family doctor's recommendation positively impact the preferred choice for a private hospital for non-severe health issues but not for severe health issues. Covariates like gender and age are not relevant in explaining the effects of the treatments, and educational level has a positive impact on one of the treatments: advice from the patient's environment. Satisfaction with public hospitals has a positive impact on all treatments.

Conclusions

Results indicate that waiting time is a key factor in choosing a private hospital against the majority-stated preference for a public hospital.

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来源期刊

Journal of Healthcare Quality Research Medicine-Health Policy

CiteScore

1.70

自引率

8.30%

发文量

审稿时长

57 days

期刊介绍： Revista de Calidad Asistencial (Quality Healthcare) (RCA) is the official Journal of the Spanish Society of Quality Healthcare (Sociedad Española de Calidad Asistencial) (SECA) and is a tool for the dissemination of knowledge and reflection for the quality management of health services in Primary Care, as well as in Hospitals. It publishes articles associated with any aspect of research in the field of public health and health administration, including health education, epidemiology, medical statistics, health information, health economics, quality management, and health policies. The Journal publishes 6 issues, exclusively in electronic format. The Journal publishes, in Spanish, Original works, Special and Review Articles, as well as other sections. Articles are subjected to a rigorous, double blind, review process (peer review)