Department of Public Health and Caring Sciences, University Hospital Uppsala, Sweden.
J Health Serv Res Policy. 2012 Apr;17(2):101-5. doi: 10.1258/jhsrp.2011.011070. Epub 2012 Feb 8.
Choice of provider was introduced in Sweden in 2001. Our aim was to describe the scope and character of patient flows and to analyze any differences between patients who chose to move outside of their home county (movers) and those who did not (non-movers) with regard to age, sex, waiting time and level of need.
Use of cataract operations between 2005 and 2008 based on data from the National Cataract Register. Data were analysed using descriptive statistics, odds ratios and multivariate regression analysis to compare movers and non-movers. Information on contracting between county councils and providers in other counties was obtained from a survey.
Only 4% of cataract patients were treated by a provider outside their home county. Patient flows were mainly determined by contracts between county councils and providers, and only 1% were considered to be 'true' movers (i.e. patients who were not part of any special contracting agreement). Movers differed from non-movers in that they were on average younger, had less serious visual problems and had shorter waiting times.
Though patient flows are minor in scope, the possibility of changing provider has probably been important in tackling long waits in some counties. However, the reform may threaten the equity of health care use.
在 2001 年，瑞典引入了选择医生的制度。我们的目的是描述患者流动的范围和特征，并分析那些选择离开自己所在县就医的患者（流动患者）和那些没有选择离开的患者（非流动患者）之间在年龄、性别、等待时间和需求水平方面的差异。
利用 2005 年至 2008 年全国白内障登记处的数据，基于白内障手术使用情况进行分析。使用描述性统计、优势比和多变量回归分析来比较流动患者和非流动患者。县议会与其他县的提供者之间的合同信息来自一项调查。
只有 4%的白内障患者在自己所在县以外的地方接受治疗。患者流动主要由县议会和提供者之间的合同决定，只有 1%的患者被认为是“真正”的流动患者（即不属于任何特殊合同协议的患者）。流动患者与非流动患者不同，他们的平均年龄更小，视力问题较轻，等待时间更短。
尽管患者流动的范围很小，但在一些县，改变医生的可能性可能在解决长时间等待方面发挥了重要作用。然而，这种改革可能会威胁到医疗保健的公平使用。
