Dataset Information

Does Quality Affect Patients' Choice of Doctor? Evidence from England.

ABSTRACT: Reforms giving users of public services choice of provider aim to improve quality. But such reforms will work only if quality affects choice of provider. We test this crucial prerequisite in the English health care market by examining the choice of 3.4 million individuals of family doctor. Family doctor practices provide primary care and control access to non-emergency hospital care, the quality of their clinical care is measured and published and care is free. In this setting, clinical quality should affect choice. We find that a 1 standard deviation increase in clinical quality would increase practice size by around 17%.

SUBMITTER: Santos R

PROVIDER: S-EPMC5349292 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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Does Quality Affect Patients' Choice of Doctor? Evidence from England.

Santos Rita R Gravelle Hugh H Propper Carol C

Economic journal (London, England) 20160223 600

Reforms giving users of public services choice of provider aim to improve quality. But such reforms will work only if quality affects choice of provider. We test this crucial prerequisite in the English health care market by examining the choice of 3.4 million individuals of family doctor. Family doctor practices provide primary care and control access to non-emergency hospital care, the quality of their clinical care is measured and published and care is free. In this setting, clinical quality ...[more]

PMID: 28356602

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Project description:BackgroundNowadays, patients are seeking physician information more frequently via the internet. Physician-rating websites (PRWs) have been recognized as the most convenient way to gain insight and detailed information about specific physicians before receiving consultation. However, little is known about how the information provided on PRWs may affect patients' decisions to seek medical advice.ObjectiveThis study aimed to examine whether the physicians' online efforts and their reputation have a relationship with patients' choice of physician on PRWs.MethodsA model, based on social exchange theory, was developed to analyze the factors associated with the number of online patients. A 3-wave data collection exercise, covering 4037 physicians on China's Good Doctor website, was conducted during the months of February, April, and June 2017. Increases in consultation in a 60-day period were used as the dependent variable, whereas 2 series of data were analyzed using linear regression modeling. The fixed-effect model was used to analyze the 3-wave data.ResultsThe adjusted R2 value in the linear regression models were 0.28 and 0.27, whereas in the fixed-effect model, it was .30. Both the linear regression and fixed-effect models yielded a good fit. A positive effect of physicians' effort on the aggregated number of online patients was identified in all models (R2=0.30 and R2=0.37 in 2 regression models; R2=0.23 in fixed effect model; P<.001). The proxies of physicians' reputations indicated different results, with total number of page views of physicians' homepages (R2=0.43 and R2=0.46; R2=0.16; P<.001) and number of votes received (R2=0.33 and R2=0.27; R2=0.43; P<.001) being seen as positive. Virtual gifts were not significant in all models, whereas thank-you messages were only significant in the fixed-effect model (R2=0.11; P=.02). The effort made by physicians online is positively associated with their aggregated number of patients consulted, whereas the effect of a physician's reputation remains uncertain. The control effect of a physician's title and hospital's level was not significant in all linear regressions.ConclusionsBoth the effort and reputation of physicians online contribute to the increased number of online patients' consultation; however, the influence of a physician's reputation varies. This may imply that physicians' online effort and reputation are critical in attracting patients and that strategic manipulation of physician profiles is worthy of study. Practical insights are also discussed.

Dataset Information

Does Quality Affect Patients' Choice of Doctor? Evidence from England.

Publications

Does Quality Affect Patients' Choice of Doctor? Evidence from England.

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