The value of choice: a qualitative study.
BACKGROUND
Providing choice in health care is part of an ongoing policy initiative.


OBJECTIVE
To explore how people understand choice in healthcare provision.


METHODS
A qualitative study using semi-structured interviews.


METHODS
South East England.


METHODS
Twenty-two people were interviewed about the issue of choice in general, and choice in healthcare in particular. Data were analysed using template analysis.


RESULTS
Participants discussed choice in the NHS within the context of the GP consultation. Four main themes about choice were identified: positive aspects of choice; the appearance of choice; unwanted choice; and the role of information in choice. Participants valued choice in principle, and having choice was seen as positive. However, the provision of choice options was not always associated with the possibility of meaningful choice. Participants expressed that in some instances they were given the appearance rather than the substance of choice. Making - as opposed to having - choice was often unwanted and considered as indicative of erosion in trust in the GP. Information was seen as a necessary, but not sufficient, prerequisite of informed choice.


CONCLUSIONS
People value having choices rather than making choices but are concerned about choice provision for its own sake rather than choice that is available in a meaningful way. Health care policy that recommends an increase in choice per se may be met with scepticism which could ultimately undermine, rather than promote, the doctor-patient relationship.
Barnett
Julie
J
Department of Psychology, University of Surrey, Guildford, UK. j.barnett@surrey.ac.uk
Ogden
Jane
J
Daniells
Emma
E
D000293:Adolescent; D000328:Adult; D002755:Choice Behavior; D004739:England; D005194:Family Practice / Q000639:trends*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology* / Q000639:trends; D017060:Patient Satisfaction; D010817:Physician-Patient Relations
J Pers Soc Psychol. 2000 Dec;79(6):995-1006
11138768
BMJ. 2004 Jul 10;329(7457):61-2
15242883
J Pers Soc Psychol. 2004 Sep;87(3):312-26
15382982
Psychol Health Med. 2009 Jan;14(1):34-47
19085310
Br J Gen Pract. 2007 Oct;57(543):822-6
17925141
Br J Gen Pract. 2008 Sep;58(554):614-8
18801278
J Pers Soc Psychol. 1999 Mar;76(3):349-66
10101874