Rademakers Jany, Nijman Jessica, Brabers Anne E M, de Jong Judith D, Hendriks Michelle
NIVEL - Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Health Policy. 2014 Feb;114(2-3):200-6. doi: 10.1016/j.healthpol.2013.07.020. Epub 2013 Aug 23.
Active provider choice by patients has become an important policy theme in western, countries over the last decades. However, not many patients and consumers exercise their right to, choose. Both health literacy and patient activation are likely to have an impact on the choice process. In, this article the relative effect of health literacy and patient activation on provider choice in the, Netherlands is studied. A questionnaire was sent to a representative sample of 2000 Dutch citizens. The questionnaire, included a measure of functional health literacy, the Dutch version of the Patient Activation Measure, and questions assessing active provider choice, reasons not to engage in it and other ways of provider, selection. The majority of respondents (59.6%) would not search for information on the basis of which they, could select the best provider or hospital. Most people rely on their general practitioner's advice. Both, low literacy and lower patient activation levels were negatively associated with active provider choice. In a regression analysis gender, education and patient activation proved the most important, predictors. The policy focus on active provider choice might result in inequity, with men, less educated, and less activated people being at a disadvantage.
在过去几十年里，患者主动选择医疗服务提供者已成为西方国家一个重要的政策主题。然而，行使选择权的患者和消费者并不多。健康素养和患者积极性可能都会对选择过程产生影响。本文研究了荷兰健康素养和患者积极性对医疗服务提供者选择的相对影响。向2000名荷兰公民的代表性样本发放了问卷。问卷包括一项功能性健康素养测量、荷兰版的患者积极性测量，以及评估主动选择医疗服务提供者、不这样做的原因和其他选择医疗服务提供者方式的问题。大多数受访者（59.6%）不会基于能选择最佳医疗服务提供者或医院的信息去搜索。大多数人依赖全科医生的建议。低素养和较低的患者积极性水平都与主动选择医疗服务提供者呈负相关。在回归分析中，性别、教育程度和患者积极性被证明是最重要的预测因素。对主动选择医疗服务提供者的政策关注可能会导致不公平，男性、受教育程度较低者以及积极性较低的人会处于不利地位。
