Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Patient choice and socioeconomic disparities in the quality of healthcare : Evidence from Swedish registry data

Ellegård, Lina Maria LU ; Kjellsson, Gustav LU ; Kovacs, Roxanne and Zhao, Yuejun (2025) In Social Science and Medicine 383.
Abstract

This study explores socioeconomic disparities in how patients trade off quality against other features when choosing their primary care provider. We use a unique registry dataset linking the choices of individuals who recently moved to a new market, and therefore need to select a new provider, with detailed individual-level measures of socioeconomic status (SES) and provider-level measures of patient satisfaction, clinical quality and travel distance in a large Swedish region. We find significant disparities in patient choice based on SES, as high-SES individuals are consistently more likely to select higher quality providers. However, the results also suggest that most of the SES disparities in observed quality are linked to... (More)

This study explores socioeconomic disparities in how patients trade off quality against other features when choosing their primary care provider. We use a unique registry dataset linking the choices of individuals who recently moved to a new market, and therefore need to select a new provider, with detailed individual-level measures of socioeconomic status (SES) and provider-level measures of patient satisfaction, clinical quality and travel distance in a large Swedish region. We find significant disparities in patient choice based on SES, as high-SES individuals are consistently more likely to select higher quality providers. However, the results also suggest that most of the SES disparities in observed quality are linked to differences in the availability of high-quality providers within an acceptable travel distance. Our findings suggest that patient choice can widen, rather than reduce, disparities in population health by SES - if spatial inequalities in access to high-quality care are not addressed beforehand.

(Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Social Science and Medicine
volume
383
article number
118351
publisher
Elsevier
external identifiers
  • scopus:105010900665
  • pmid:40690882
ISSN
1873-5347
DOI
10.1016/j.socscimed.2025.118351
language
English
LU publication?
yes
additional info
Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.
id
9fd69033-78f3-4b7e-9b85-ba89f8a1e75c
date added to LUP
2025-07-23 21:55:10
date last changed
2025-08-21 06:53:22
@article{9fd69033-78f3-4b7e-9b85-ba89f8a1e75c,
  abstract     = {{<p>This study explores socioeconomic disparities in how patients trade off quality against other features when choosing their primary care provider. We use a unique registry dataset linking the choices of individuals who recently moved to a new market, and therefore need to select a new provider, with detailed individual-level measures of socioeconomic status (SES) and provider-level measures of patient satisfaction, clinical quality and travel distance in a large Swedish region. We find significant disparities in patient choice based on SES, as high-SES individuals are consistently more likely to select higher quality providers. However, the results also suggest that most of the SES disparities in observed quality are linked to differences in the availability of high-quality providers within an acceptable travel distance. Our findings suggest that patient choice can widen, rather than reduce, disparities in population health by SES - if spatial inequalities in access to high-quality care are not addressed beforehand.</p>}},
  author       = {{Ellegård, Lina Maria and Kjellsson, Gustav and Kovacs, Roxanne and Zhao, Yuejun}},
  issn         = {{1873-5347}},
  language     = {{eng}},
  month        = {{07}},
  publisher    = {{Elsevier}},
  series       = {{Social Science and Medicine}},
  title        = {{Patient choice and socioeconomic disparities in the quality of healthcare : Evidence from Swedish registry data}},
  url          = {{http://dx.doi.org/10.1016/j.socscimed.2025.118351}},
  doi          = {{10.1016/j.socscimed.2025.118351}},
  volume       = {{383}},
  year         = {{2025}},
}