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Does patient choice of healthcare providers lead to better patient experiences in the Netherlands? A cross-sectional questionnaire study (2014).

Victoor, A., Reitsma-van Rooijen, M., Jong, J. de, Delnoij, D., Friele, R., Rademakers, J. Does patient choice of healthcare providers lead to better patient experiences in the Netherlands? A cross-sectional questionnaire study (2014). European Journal of Public Health: 2014, 24(suppl. 2) 23. Abstract: 7th European Public Health Conference 'Mind the Gap: Reducing Inequalities in health and health care'. 19-22 November 2014, Glasgow.
<strong>Background:</strong> Various European healthcare systems encourage patients to make an active choice of healthcare provider, both as a worthwhile effort for patients and an instrument to encourage competition between providers. In previous research, patient groups were distinguished regarding patients’ hospital selection process: patients without choice opportunity, passive patients, patients choosing the default hospital and patients displaying choice activity. This study describes these patient groups in more detail and explores the relationship between patient choice (both as an instrument and a goal) and patient experiences.
<strong>Methods:</strong> In January 2014, a questionnaire was ent to 1500 members of the ‘‘Dutch Health Care Consumer Panel’’. Questions concerned patients’ hospital selection process, possible determinants of patients’ choices and patients’ experiences with the care they received.
<strong>Results:</strong> Consistent with existing literature, we categorized patients into four different main groups with regard to the way they selected a hospital. Relatively few patients displayed choice activity and even these patients visited a hospital based on other factors than its quality. Passive patients did not have worse care experiences than patients who displayed choice activity, but their hospital visits led to smaller health improvements. Patients without choice opportunity had worse patient experiences than their counterparts.
<strong>Conclusions:</strong> Patient choice seems to be a worthwhile effort. However, relatively few patients make active hospital choices and even they select a hospital based on other factors than its quality. It can therefore be questioned whether enough patients choose actively to encourage providers to compete. Policy makers might need to adjust their current expectations regarding the effects of the policy on patient choice. The abstract is included in the workshop because its subject matches the scope of the workshop and a presentation covering the effect of patient choice of providers in the Netherlands would be a nice supplement to the other presentations.
<strong>Key messages:</strong>
- Patient choice is a worthwhile for patients.
- It can be questioned if the level of competitive pressure arising from patients in the provider market is sufficient for stimulating competition.
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