Patient’s Choice of Healthcare Facility in Private and Public Segments of Healthcare – Evidence from Patients, Suffering from Borderline Psychic Disorders

<p><strong>Introduction</strong> High prevalence of borderline psychic disorders, their economic impact combined with slow healthcare seeking, which is the result of poor access to healthcare, makes important the consumer&#39;s choice of this category of patients. According to the model of consumer-driven competition there are different factors of choice healthcare facility by patients, the key role of consumer satisfaction in repeated visits of patients is shown, different factors of satisfaction are described. But the weight f these factors varies according to different studies and in particular it depends on healthcare segment. There is only few studies of these factors in field of psychiatry and in Russia. <u>The aim</u> is to study the factors of choice of healthcare facility in public and private segments of healthcare in patients suffering from borderline psychic disorders. <strong>Material</strong>: primary outpatients of private psychiatric clinic (n=118), 100 of whom saw the web-site of the clinic; inpatients of public psychiatric clinic - 189 of them were primary and 100 were hospitalized repeatedly.<strong> Method</strong>: quantitative PaPi survey using the standardized questionnaires <strong>Results</strong>:</p><p>1. The characteristics of patients referral during prehospital stage are:</p><ul><li>only 25% of patients are consulted by psychiatrists, which can result low treatment quality</li><li>half of patients contact the doctor to achieve appointment card to hospitalization and most of them receive these cards not been proposed outpatient treatment - it reflects violation of the natural process and stages of treatment and indicates inefficient for healthcare system consumer choice</li><li>not proposing alternative variants of inpatient facilities by healthcare providers (despite their presence), which increases the risk of refuse from hospitalization of patients unsatisfied with their previous hospitalization to the studied facility</li><li>retention of information asymmetry about healthcare facility between doctor and patient when giving patient appointment card to hospitalization</li></ul><ol><li value="2">In public segment oh healthcare primary inpatients represent the heterogenic groups different in structure medical facility choice factors and type of competition</li></ol><p>2.1 Among patients, for whom appointment card for hospitalization is the leading factor if choice half of patients consider this only factor as important. These patients rarely contact the doctor specially to achieve appointment card to hospitalization. In complex this allows to consider these patients from point of view of purchaser-driven competition.</p><p>2.2 Patients, who do not take into consideration the appointment card for hospitalization when choosing the hospital, are guided by friends and patients recommendations, specialization focused on treatment of their diseases and methods of treatment used, which corresponds with factors of choice of private outpatient psychiatric clinic. This group of patients are intent to contact the doctor specially to achieve appointment card to hospitalization. In complex this allows to consider these patients from point of view of consumer-driven competition.</p><ol><li value="3">Among patients repeatedly hospitalized to public psychiatric hospital key factors of satisfaction of their previous hospitalization are quality of work of medical personnel, volume and quality of psychotherapeutic treatment and physiotherapy</li><li value="4">In private segment of healthcare when choosing healthcare facility primary patients take into consideration description of doctor and methods of treatment at web-site, general impression from web-site, specialization focused on treatment of their diseases and presence of doctors being PhD</li><li value="5">When evaluating the web-site of the private psychiatric clinic primary outpatients consider medical information, description of doctors and methods of treatment. Usability of the web-site and site design are also important factors.</li></ol>