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When do people choose to be informed? Predictors of information-seeking in the choice of primary care provider in Sweden

Published online by Cambridge University Press:  03 August 2018

Caroline Hoffstedt Open the ORCID record for Caroline Hoffstedt [Opens in a new window] ,
Magnus Fredriksson ,
Håkan Lenhoff  and
Ulrika Winblad
Caroline Hoffstedt*
Affiliation:
PhD Student, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
Magnus Fredriksson
Affiliation:
Associate Professor, Department of Journalism, Media and Communication, University of Gothenburg, Gothenburg, Sweden
Håkan Lenhoff
Affiliation:
Analysis manager, Healthcare Administration, Värmland County Council, Karlstad, Sweden
Ulrika Winblad
Affiliation:
Associate Professor, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
*
*Correspondence to: Caroline Hoffstedt, Department of Public Health and Caring Sciences, Uppsala University, Health Services Research, Box 564 75122, Uppsala, Sweden. Email: caroline.hoffstedt@pubcare.uu.se
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Abstract

Improving the ability of patients to make informed choices of health care provider can give providers more incentive to compete based on quality. Still, it is not evident to what extent and when people search for information when choosing a provider. The aim of this study is to identify under what circumstances individuals seek information when choosing a primary care provider. Research to date has mostly focused on individuals’ demographic and socio-economic characteristics and the poor availability of information as barriers to information-seeking and use. Our results highlight the importance of taking individuals’ personal motivations and situational context into account when studying information-seeking behavior. Overall, these results suggest that not even individuals who are likely to search for information since they switched or considered switching primary care provider, do so to any greater extent. However, those motivated to change providers by internal factors such as dissatisfaction or a belief that other providers may provide superior services actively sought out information to a greater extent than those motivated by external factors such as the closure of their current provider, or by moving house. Gender, employment status, place of residence and education level was also significantly associated with information-seeking.

Keywords

provider choicepatient choiceinformation searchpublic reportingprimary care
Type
Articles
Information
Health Economics, Policy and Law , Volume 15 , Issue 2 , April 2020 , pp. 210 - 224
Copyright
© Cambridge University Press 2018

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Footnotes

a

Visiting address: BMC, Husargatan 3.

References

1177 Vårdguiden (2015) Hitta Och Jämför Vård. https://www.1177.se/Uppsala-lan/Hitta-vard/Om-Hitta-och-jamfor-vard/?ar=True [15 March 2018].Google Scholar
Andersson, F, Janlöv, N and Rehnberg, C (2014) Konkurrens, kontrakt och kvalitet – Hälso- och sjukvård i privat regi. Stockholm.Google Scholar
Anell, A, Glenngard, AH and Merkur, S (2012) Sweden: health system review. Health Systems in Transition 14(5), 1–159.Google ScholarPubMed
Belkin, NJ, Oddy, RN and Brooks, H M (1982) Ask for information retrieval: Part I. Background and theory. Journal of Documentation 38(2), 61–71.CrossRefGoogle Scholar
Bevan, G, Helderman, JK and Wilsford, D (2010) Changing choices in health care: implications for equity, efficiency and cost. Health Economics, Policy, and Law 5(3), 251–267.CrossRefGoogle ScholarPubMed
Case, DO (2007) Looking for Information [Electronic Resource]: A Survey of Research on Information Seeking, Needs, and Behavior. Library and Information Science Series, Amsterdam: Elsevier/Academic Press.Google Scholar
Dervin, B, Foreman-Wernet, L and Lauterbach, E (2003) Sense-Making Methodology Reader: Selected Writings of Brenda Dervin Cresskill, NJ: Hampton Press.Google Scholar
Donelan, K, Rogers, RS, Eisenhauer, A, Mort, E and Agnihotri, AK (2011) Consumer comprehension of surgeon performance data for coronary bypass procedures. The Annals of Thoracic Surgery 91(5), 1400–1406.CrossRefGoogle ScholarPubMed
Fasolo, B, Reutskaja, E, Dixon, A and Boyce, T (2010) Helping patients choose: how to improve the design of comparative scorecards of hospital quality. Patient Education and Counseling 78(3), 344–349.CrossRefGoogle ScholarPubMed
Findahl, O and Davidsson, P (2016) Svenskarna och internet – 2016 års undersökning av svenska folkets internetvanor [The Swedes and the Internet – 2016 survey of the Swedish people’s internet habits], Stockholm: Internetstiftelsen i Sverige.Google Scholar
Fredriksson, M, Blomqvist, P and Winblad, U (2013) The trade-off between choice and equity: Swedish policymakers’ arguments when introducing patient choice. Journal of European Social Policy 23(2), 192–209.CrossRefGoogle Scholar
Galizzi, MM, Miraldo, M, Stavropoulou, C, Desai, M, Jayatunga, W, Joshi, M and Parikh, S (2012) Who is more likely to use doctor-rating websites, and why? A cross-sectional study in London. BMJ Open 2012(2), e001493.CrossRefGoogle Scholar
Glynn, CJ, Herbst, S, Lindeman, M, O’Keefe, GJ and Shapiro, RY (2015) Public Opinion, 3rd edn, Boulder, CO: Westview Press Inc.Google Scholar
Grunig, JE (1989) Publics, audiences and market segments: segmentation principles for campaigns. In CT Salmon (ed.) Information Campaigns: Balancing Social Values and Social Change, Newbury Park, CA: Sage Publications.Google Scholar
Grunig, JE (1997) A situational theory of publics: conceptual history, recent challenges and new research. In D Moss, T MacManus and D Vercic (eds) Public Relations Research: An International Perspective, London: International Thompson Business Press.Google Scholar
Hanoch, Y and Rice, T (2011a) The economics of choice: lessons from the U.S. health-care market. Health Expectations 14(1), 105–112.CrossRefGoogle ScholarPubMed
Hanoch, Y, Wood, S, Barnes, A, Liu, PJ and Rice, T (2011b) Choosing the right Medicare prescription drug plan: the effect of age, strategy selection and choice set size. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association 30(6), 719–727.CrossRefGoogle ScholarPubMed
Harris, KM (2003) How do patients choose physicians? Evidence from a national survey of enrollees in employment-related health plans. Health Services Research 38(2), 711–732.CrossRefGoogle ScholarPubMed
Hibbard, JH, Greene, J and Daniel, D (2010) What is quality anyway? Performance reports that clearly communicate to consumers the meaning of quality of care. Medical Care Research and Review 67(3), 275–293.CrossRefGoogle ScholarPubMed
Hibbard, JH, Peters, E, Dixon, A and Tusler, M (2007) Consumer competencies and the use of comparative quality information: it isn’t just about literacy. Medical Care Research and Review 64(4), 379–394.CrossRefGoogle ScholarPubMed
Hibbard, JH, Peters, E, Slovic, P, Finucane, ML and Tusler, M (2003) Making health care quality reports easier to use. Joint Commission Journal on Quality and Patient Safety 27(11), 591–604.Google Scholar
Hoerger, TJ and Howard, LZ (1995) Search behavior and choice of physician in the market for prenatal care. Medical Care 33(4), 332–349.CrossRefGoogle ScholarPubMed
Isaksson, D, Blomqvist, P and Winblad, U (2016) Free establishment of primary health care providers: effects on geographical equity. BMC Health Services Research 16(1), 28.CrossRefGoogle ScholarPubMed
Ketelaar, N, Braspenning, JC, Faber, MJ, Westert, GP and Elwyn, G (2014a) Exploring consumer values of comparative performance information for hospital choice. Quality in Primary Care 22: 81–89.Google ScholarPubMed
Ketelaar, N, Faber, MJ, Braspenning, JC and Westert, GP (2014b) Patients’ expectations of variation in quality of care relates to their search for comparative performance information. BMC Health Services Research 14(1), 617.CrossRefGoogle ScholarPubMed
Konkurrensverket (2014) Etablering och konkurrens bland vårdcentraler – Om kvalitetsdriven konkurrens och ekonomiska villkor. Report 2014:2 [Establishment And Competition Among Primary Care Centers – About Quality-Driven Competition and Economic Conditions]. Stockholm.Google Scholar
Kuhlthau, CC (1993) A principle of uncertainty for information seeking. Journal of Documentation 49(4), 339–355.CrossRefGoogle Scholar
Kuhlthau, CC (2004) Seeking Meaning: A Process Approach to Library and Information Services, 2nd edn, Westport, CT: Libraries Unlimited.Google Scholar
Le Grand, J (2007) The Other Invisible Hand: Delivering Public Services Through Choice and Competition, Princeton, NJ: Princeton University Press.Google Scholar
Le Grand, J (2009) Choice and competition in publicly funded health care. Health Economics, Policy and Law 4(4), 479–488.CrossRefGoogle ScholarPubMed
Le Grand, J and Bartlett, W (1993) Quasi-Markets and Social Policy, London: Macmillan.CrossRefGoogle Scholar
Myndigheten för vård- och omsorgsanalys (2013) Vad vill patienten veta för att välja? Vårdanalys utvärdering av vårdvalsinformation. [What do patients want to know when choosing? An evaluation of comparative information by The Swedish Agency for Health and Care Service Analysis]. Stockholm.Google Scholar
Myndigheten för vård- och omsorgsanalys (2017) Primärvården i belysning – Jämförelser mellan landsting och regioner 2011-2015. [Primary Care Illustrated – Comparisons between county councils and regions 2011-2015]. Stockholm.Google Scholar
Neuman, WR and Guggenheim, L (2011) The evolution of media effects theory: a six-stage model of cumulative research. Communication Theory 21(2), 169–196.CrossRefGoogle Scholar
Peters, E, Dieckmann, N, Dixon, A, Hibbard, JH and Mertz, CK (2007) Less is more in presenting quality information to consumers. Medical Care Research and Review 64(2), 169–190.CrossRefGoogle Scholar
Rademakers, J, Nijman, J, Brabers, A, de Jong, JD and Hendriks, M (2014) The relative effect of health literacy and patient activation on provider choice in the Netherlands. Health Policy (Amsterdam, Netherlands) 114(2–3), 200–206.CrossRefGoogle ScholarPubMed
Saltman, RB and Bergman, SE (2005) Renovating the commons: Swedish health care reforms in perspective. Journal of Health Politics, Policy & Law 30(1–2), 253–275.CrossRefGoogle Scholar
Schlesinger, M (2010) Choice cuts: parsing policymakers’ pursuit of patient empowerment from an individual perspective. Health Economics, Policy, and Law 5(3), 365–387.CrossRefGoogle ScholarPubMed
Schwartz, LM, Woloshin, S and Birkmeyer, JD (2005) How do elderly patients decide where to go for major surgery? Telephone interview survey. British Medical Journal 331(7520), 821.CrossRefGoogle ScholarPubMed
Socialstyrelsen (2010) Införandet av vårdval i primärvården – Slutredovisning. Report 2010-2-10 [The Introduction of Choice in Primary Care Stockholm – Final Report].Google Scholar
Statistiska centralbyrån (2013a) Befolkning 16-95+ år efter region, utbildningsnivå, ålder och kön. År 2008 – 2014. [Population 16-95+years by region, education level, age and gender. Years 2008–2014]. Befolkningsstatistik, Befolkningens Utbildning.Google Scholar
Statistiska centralbyrån (2013b) Befolkning efter ålder och kön. år 1860–2015. [Population by age and gender. Years 1860-2015]. Statistikdatabasen, Befolkningsstatistik.Google Scholar
Statistiska centralbyrån (2013c) Frånvarande från arbetet/frånvarotimmar 15-74 år under referensveckan (AKU) efter frånvaroorsak, kön och ålder. År 2005–2015, Hela referensveckan 1000-tal personer. [Absent from work/absence hours, 15-74 years, during the reference week (AKU) reason for absence, sex and age. Years 2005–2015, the entire reference week 1000s people]. Arbetskraftsundersökningarna (AKU).Google Scholar
Statistiska centralbyrån (2013d) Grundtabeller AKU, 15–74 år, kvartal (2 Tabell 16. [Basic Tables AKU, 15–74 years, quarter (2), Table 16]. Arbetskraftsundersökningarna (AKU).Google Scholar
Statistiska centralbyrån (2013e) Grundtabeller AKU, 15–74 år, kvartal (2 Tabell 2. [Basic Tables AKU, 15–74 years, quarter (2), Table 2]. Arbetskraftsundersökningarna (AKU).Google Scholar
Statistiska centralbyrån (2013f) Sammanräknad förvärvsinkomst för boende i Sverige hela året (Antal personer, medel- och medianinkomst samt totalsumma) efter kön, inkomstklass och ålder i 1-Årsklasser. År 1999-2014. [Total earned income for residents in Sweden throughout the year (number of people, average and median income and sum total) by gender, income bracket and age in one-year classes. Years 1999-2014] Statistikdatabasen, Hushållens Ekonomi.Google Scholar
Statistiska centralbyrån (2013g) Utbildningsnivå för befolkningen efter inrikes/utrikes född, kön och åldersgrupp 2014. [Education level of the population for domestic/foreign born, sex and age group, 2014]. Befolkningens Utbildning.Google Scholar
Statistiska centralbyrån (2013h Utrikes Födda Efter Födelseland, Kön Och År. 2000-2015. [Foreign-born by country of birth, sex and year. 2000-2015]. Statistikdatabasen, Befolkningsstatistik.Google Scholar
Sveriges Kommuner och Landsting (2013) Bilaga A Frekvenstabell 2013, Q 36. [Appendix A, frequency Table 2013, Q36]. Vårdbarometern, Frekvenstabell.Google Scholar
Sveriges Riksdag (2008) Lag (2008:962) Om Valfrihetssystem. Sweden: Stockholm.Google Scholar
Sveriges Riksdag (2014) Lag (2014:822) Om ändring i Hälso- och sjukvårdslagen. [Act (2014:822) About Revision in the Health Care Legislation]. Sweden: Stockholm.Google Scholar
Taylor, RS (1962) The process of asking questions. American Documentation 13(4), 391–396.CrossRefGoogle Scholar
Tu, TH and Lauer, JR (2008) Word of mouth and physician referrals still drive health care provider choice. Research Brief 9: 1–8.Google Scholar
Victoor, A, Delnoij, D, Friele, R and Rademakers, J (2016) Why patients may not exercise their choice when referred for hospital care. An exploratory study based on interviews with patients. Health Expectations 19(3), 667–678.CrossRefGoogle Scholar
Victoor, A, Rademakers, J, Reitsma-van Rooijen, M, de Jong, J, Delnoij, D and Friele, R (2014) The effect of the proximity of patients’ nearest alternative hospital on their intention to search for information on hospital quality. Journal of Health Services Research & Policy 19(1), 4–11.CrossRefGoogle ScholarPubMed
Zwijnenberg, NC, Hendriks, M, Damman, OC, Bloemendal, E, Wendel, S, de Jong, J and Rademakers, J (2012) Understanding and using comparative healthcare information; the effect of the amount of information and consumer characteristics and skills. BMC Medical Informatics and Decision Making 12(1), 101.CrossRefGoogle ScholarPubMed