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Simply the best? The impact of quality on choice of primary healthcare provider in Sweden

Dahlgren, Cecilia ; Dackehag, Margareta LU orcid ; Wändell, Per LU and Rehnberg, Clas (2021) In Health Policy 125(11). p.1448-1454
Abstract

Objective: One of the more important objectives with the patient choice reform, introducing non-price competition in Swedish primary healthcare, was to improve performance and quality of care. However, in order for choice to lead to quality improvements, citizens need to consider quality aspects in their choices of provider. We hypothesize that quality of care influences choice of provider and the objective of this study is to investigate if citizens are willing to make a trade-off between distance to chosen provider and quality of care. Methods: We use conditional logit models to analyse if quality and other provider attributes influence choice of provider. The study population includes all citizens of Region Stockholm with at least... (More)

Objective: One of the more important objectives with the patient choice reform, introducing non-price competition in Swedish primary healthcare, was to improve performance and quality of care. However, in order for choice to lead to quality improvements, citizens need to consider quality aspects in their choices of provider. We hypothesize that quality of care influences choice of provider and the objective of this study is to investigate if citizens are willing to make a trade-off between distance to chosen provider and quality of care. Methods: We use conditional logit models to analyse if quality and other provider attributes influence choice of provider. The study population includes all citizens of Region Stockholm with at least one primary healthcare contact (N ~1.4 million). Results: The results show that distance is the most important factor in choosing a primary healthcare provider but that there seems to be a willingness to make a trade-off between distance and quality measures. However, other provider attributes, such as the Care Need Index of the registered population, seem to influence choice to a greater extent than quality. Conclusion: The results point in the same direction as the arguments behind the patient choice reform. However, the effects are marginal. To enhance quality competition, policy makers should consider making quality information at the provider level more accessible.

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Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Health care Reform, Health Economics, Patient choice, Primary healthcare, Sweden
in
Health Policy
volume
125
issue
11
pages
7 pages
publisher
Elsevier
external identifiers
  • scopus:85116911045
  • pmid:34645569
ISSN
0168-8510
DOI
10.1016/j.healthpol.2021.09.009
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021
id
0c018d60-6f00-4cde-9c16-88ec35c20a09
date added to LUP
2021-11-12 15:44:49
date last changed
2024-06-15 20:10:04
@article{0c018d60-6f00-4cde-9c16-88ec35c20a09,
  abstract     = {{<p>Objective: One of the more important objectives with the patient choice reform, introducing non-price competition in Swedish primary healthcare, was to improve performance and quality of care. However, in order for choice to lead to quality improvements, citizens need to consider quality aspects in their choices of provider. We hypothesize that quality of care influences choice of provider and the objective of this study is to investigate if citizens are willing to make a trade-off between distance to chosen provider and quality of care. Methods: We use conditional logit models to analyse if quality and other provider attributes influence choice of provider. The study population includes all citizens of Region Stockholm with at least one primary healthcare contact (N ~1.4 million). Results: The results show that distance is the most important factor in choosing a primary healthcare provider but that there seems to be a willingness to make a trade-off between distance and quality measures. However, other provider attributes, such as the Care Need Index of the registered population, seem to influence choice to a greater extent than quality. Conclusion: The results point in the same direction as the arguments behind the patient choice reform. However, the effects are marginal. To enhance quality competition, policy makers should consider making quality information at the provider level more accessible.</p>}},
  author       = {{Dahlgren, Cecilia and Dackehag, Margareta and Wändell, Per and Rehnberg, Clas}},
  issn         = {{0168-8510}},
  keywords     = {{Health care Reform; Health Economics; Patient choice; Primary healthcare; Sweden}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1448--1454}},
  publisher    = {{Elsevier}},
  series       = {{Health Policy}},
  title        = {{Simply the best? The impact of quality on choice of primary healthcare provider in Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.healthpol.2021.09.009}},
  doi          = {{10.1016/j.healthpol.2021.09.009}},
  volume       = {{125}},
  year         = {{2021}},
}