Journal of Health Services Research & Policy > Volume 13, Number 3 > Pp. 178-184

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Fotaki, M. Articles by Smith, L. PubMed PubMed Citation Social Bookmarking                      What's this?

Review

What benefits will choice bring to patients? Literature review and assessment of implications

Marianna Fotaki , Martin Roland ¹, Alan Boyd, Ruth McDonald , Rod Scheaff ², Liz Smith

Manchester Business School, University of Manchester; ¹ National Primary Care Research and Development Centre, University of Manchester; ² Peninsula Allied Health Centre, University of Plymouth, UK

Correspondence to: Marianna.fotaki{at}mbs.ac.uk

Objectives: To assess the demand for, and likely impact of, increasing patient choice in health care. The study examined whether patients would like to exercise choice of hospital, primary care provider and treatment, and investigated the likely impact of policies designed to increase choice on equity of access, and on the efficiency and quality of service delivery.

Method: Theory-based literature review including an analysis of the intended and unintended impact of choice-related policies in health care in the UK, European Union and USA. Selected papers focused not only on offering choice to individual patients but also evidence of the impact of choice by patients' agents such as GPs, and on the impact of introducing choice in education and social services.

Results: Choosing between hospitals or primary care providers is not currently a high priority for the public, except where local services are poor, e.g. they have long waiting times and where individual patients' circumstances do not limit their ability to travel. When patients become ill, they are increasingly likely to wish to rely on a trusted health practitioner to choose their treatment. Better educated populations make greater use of information and are more likely to exercise choice in health care. The increase in inequality which this could produce might be reduced by specific provision of information and help, enabling less advantaged populations to make choices about health care. There was little evidence in the literature that providing greater choice will in itself improve efficiency or quality of care.

Conclusion: Although patients may themselves make limited use of choices, the existence of choice may, in theory, stimulate providers to improve quality of care. Patients do, however, want to be more involved in individual decisions about their own treatment, and generally participate much less in these decisions than they would wish.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?