The effect of the proximity of patients' nearest alternative hospital on their intention to search for information on hospital quality.
OBJECTIVE
In several countries, patients are encouraged to choose health care providers. Simultaneously, there is a tendency towards the concentration of health care, which might lessen the choice. Our aim was to assess the impact of patients' distances from their providers on their information-seeking, which is one element of choice.


METHODS
Two thousand members of the Dutch Health Care Consumer Panel were sent a questionnaire that included a question on whether they would search for information about hospitals to inform their choice. Distances from providers were obtained from a database that includes the distances between all postcodes in the Netherlands. To assess the influence of distance on information-seeking, logistic regression analyses were conducted.


RESULTS
There was a good response (75%). Older, less educated respondents were less inclined to seek information when their nearest alternative was located further away (OR 0.85; 95% CI: 0.79-0.92), and younger, more educated respondents were more inclined to search in this situation (OR 1.11; 95% CI: 1.01-1.22).


CONCLUSIONS
As fewer older, less educated patients would search for information to guide their choice, they might not opt for the best hospital. Additionally, the need for providers to compete for the patronage of these patients might be lessened.
NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
Aafke
A
Victoor
Jany
J
Rademakers
Margreet
M
Reitsma-van Rooijen
Judith
J
de Jong
Diana
D
Delnoij
Roland
R
Friele
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002755:Choice Behavior; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility; D006761:Hospitals / Q000592:standards* / Q000600:supply & distribution; D006801:Humans; D057226:Information Seeking Behavior; D033182:Intention; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011795:Surveys and Questionnaires; D055815:Young Adult
choice behavior; health services accessibility; managed competition