Identifying factors affecting how patients choose Public or Private Doctor for consultation and how they perceive the consultation quality

Abstract

INTRODUCTION: This study aimed to identify patients’ socio-demographic and clinical characteristics relating to their use of public and private doctor consultation and perceived consultation quality in Hong Kong. METHOD: Data from 4,740 participants of the Thematic Household Survey 2009, who aged 15 or above and had consulted Western doctors for their last consultation within the past 30 days, was analyzed. Multiple logistic regression was initially used to identify the difference in socio-demographic and clinical characteristics between these two groups of patients, followed by multiple linear regression to evaluate the independent factors affecting the patient-perceived consultation quality. RESULTS: About 60.9% (2885) and 39.1% (1855) patients consulted private and public doctor for their last consultation respectively, and they showed significant difference on many aspects of the socio-demographic background, lifestyle habit, self-evaluation of health, and presence of any chronic disease. Patients who were male, less educated, not working, with less household income, with chronic disease, and need follow-up of chronic condition were more likely to consult public doctors. Older patients, non-smokers, and those consulted private doctors were prone to have a better perceived quality with their last consultation. DISCUSSION: While patients perceived the care offered by private doctors was of better quality, bearing of chronic disease, the subsequent need of regular follow-up, and the associated financial burden make these patients select public healthcare service. Therefore, financial considerations and assistance, including incentives or subsidies, play an important role in the development of the public-private partnership model of share care for patients with chronic diseases.