Costa-i-Font, J. & Zigante, V. (2014) “Why the views of middle class citizens help explain increased choice in European healthcare systems“, LSE EUROPP, 21 Νοεμβρίου.
Several countries across Europe have attempted to reform their health systems by allowing patients more choice over their healthcare provider. The typical rationale for this strategy is that by creating competition between providers, there will be an increased incentive to improve the efficiency and quality of healthcare. Joan and Valentina Zigante assess the underlying factors that have led to European countries adopting this ‘choice agenda’ in their healthcare systems. They find that one of the key drivers for this type of reform has been the role of middle class citizens in demanding greater choice over health providers.
A key tenet of European health and consumer protection strategy lies in strengthening patient involvement in decision making. A dominant reform consistent with that goal is that of furthering provider choice, which does not always encompass widening financing choice, often referred to as the ‘choice agenda’.
For a patient to benefit from choice, health systems need to widen their service diversity, which from a provider perspective entails the introduction of some level of competition in the organisation of public services. A textbook explanation for the benefits of such a reform would go as follows: the empowerment of potential choices rewards provider performance which incentivises more efficient production and improved quality at the expense of ‘consumerism’ governing the relation between patients and providers. The Chart below shows self-reported perception of the choice available in selected European healthcare systems and the level of satisfaction citizens report in the healthcare system overall.
Note: The chart shows an estimation of the mean rating by citizens of their freedom to choose a hospital or a healthcare provider based on responses to the 2002 World Health Survey (using a numerical scale in which the higher the rating the more perceived choice there is). The chart also shows the mean level of satisfaction with health systems in each country using the same numerical scale. There is a weak but positive correlation between citizens’ satisfaction with the health system and their perceived ability to choose their provider (i.e. countries with higher levels of perceived choice also have higher levels of satisfaction).
Σχετικές αναρτήσεις:
- Eurofound (2014) Access to healthcare in times of crisis, Eurofound Surveys: EF14421, 31 Οκτωβρίου.
- Saltman, R. (2014) “Pragmatism is beginning to trump ideology in Europe’s ‘public-private’ debate over healthcare“, LSE EUROPP, 09 Οκτωβρίου.
- Missinne, Sarah, Meuleman, Bart, Bracke, Piet, (2013) “The popular legitimacy of European healthcare systems: A multilevel analysis of 24 countries“, Journal of European Social Policy, Vol. 23, Issue 3, July 2013, p.p, 231-247.