Factors influencing medical institution selection for outpatient services

ABSTRACT

This study analyzes determinants of patients' choice of healthcare providers in outpatient services and identifies their effects. Data were collected from two waves of the Korean Health Panel. The unit of analysis was an outpatient visit (n=189,739). Various types of medical institutions were grouped into general hospitals (including tertiary hospitals), hospitals, and clinics. A multinomial logit model was used to examine the determinants of medical institution selection. Clinics were the most frequent (82.2%) medical institution selected, followed by general hospitals (10.9%) and hospitals (6.9%). Males and beneficiaries of Medical Aid were more likely to choose the upper-level institutions. The upper-level institution selection was also positively associated with the level of education, household income, and severe diseases, while negatively associated with the level of health status. The medical institution selection was significantly different by region. Not only enabling factors for healthcare utilization, such as family and community resources, but also the users' characteristics were strong determinants of the type of medical institution selected. We, therefore, recommend that patients' characteristics and needs, in addition to the sharing of roles and functions among medical institutions, should be considered in making healthcare policies for efficient medical utilization and an effective medical delivery system.