Victoor Aafke, Rademakers Jany, Reitsma-van Rooijen Margreet, de Jong Judith, Delnoij Diana, Friele Roland
NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
J Health Serv Res Policy. 2014 Jan;19(1):4-11. doi: 10.1177/1355819613498380. Epub 2013 Aug 14.
In several countries, patients are encouraged to choose health care providers. Simultaneously, there is a tendency towards the concentration of health care, which might lessen the choice. Our aim was to assess the impact of patients' distances from their providers on their information-seeking, which is one element of choice.
Two thousand members of the Dutch Health Care Consumer Panel were sent a questionnaire that included a question on whether they would search for information about hospitals to inform their choice. Distances from providers were obtained from a database that includes the distances between all postcodes in the Netherlands. To assess the influence of distance on information-seeking, logistic regression analyses were conducted.
There was a good response (75%). Older, less educated respondents were less inclined to seek information when their nearest alternative was located further away (OR 0.85; 95% CI: 0.79-0.92), and younger, more educated respondents were more inclined to search in this situation (OR 1.11; 95% CI: 1.01-1.22).
As fewer older, less educated patients would search for information to guide their choice, they might not opt for the best hospital. Additionally, the need for providers to compete for the patronage of these patients might be lessened.
在一些国家，鼓励患者选择医疗服务提供者。与此同时，医疗服务有集中化的趋势，这可能会减少选择。我们的目的是评估患者与医疗服务提供者之间的距离对其信息寻求行为的影响，而信息寻求是选择行为的一个要素。
向荷兰医疗保健消费者小组的2000名成员发送了一份问卷，其中包括一个关于他们是否会搜索医院信息以指导其选择的问题。从一个包含荷兰所有邮政编码之间距离的数据库中获取与医疗服务提供者的距离。为了评估距离对信息寻求的影响，进行了逻辑回归分析。
问卷回复率良好（75%）。年龄较大、受教育程度较低的受访者，当最近的替代医疗服务提供者距离较远时，他们寻求信息的倾向较低（比值比0.85；95%置信区间：0.79 - 0.92），而年龄较小、受教育程度较高的受访者在这种情况下更倾向于搜索信息（比值比1.11；95%置信区间：1.01 - 1.22）。
由于年龄较大、受教育程度较低的患者寻求信息以指导其选择的可能性较小，他们可能不会选择最佳医院。此外，医疗服务提供者争夺这些患者光顾的必要性可能会降低。
