title: Global Health Policy and Access to Care: Investigating Patient Choice on an International Level Using Social Media.
abstract: BACKGROUND
  Increased access to transportation and information has led to the emergence of more diverse patient choice and new forms of health care consumption, such as medical travel. In order for health care providers to effectively attract patients, more knowledge is needed on the mechanisms underlying decision-making of potential travelers from different countries. A particularly promising method of studying the travelers' motives is collecting data on social media.
  
  
  OBJECTIVE
  The aim of this study was to test what factors influence decision-making of potential medical travelers and how these factors interact. Based on existing literature, the factors analyzed included quality, cost, and waiting time for 2 procedures varying in invasiveness across 12 different destination countries.
  
  
  METHODS
  Decision-making patterns were examined using a pilot questionnaire that generated a large amount of data from over 800 participants in 40 countries. Participants indicated their willingness to travel given different scenarios. Each scenario consisted of a combination of several factors. Additionally, participants were asked to indicate the reasons for their choice.
  
  
  RESULTS
  Individuals display high willingness to travel for medical care when combining all participants and scenarios, travel for care was chosen 66.9% of the time. Among the factors influencing their decisions, quality of the medical procedure abroad was considered most important, and cost was least important as shown by chi-square tests and corresponding odds ratios. Log-linear analyses revealed an interaction between time waiting in the local health care system and type of procedure, whereby time pressure increased the odds of agreeing to travel for the more invasive procedure. The odds of traveling to Europe and the USA were by far the highest, although participants indicated that under certain conditions they might be willing to travel to other medical destinations, such as Asia.
  
  
  CONCLUSIONS
  Our measurements yielded several reliable insights into the factors driving medical decision-making. An essential next step would be to expand these findings with a more encompassing sample and more elaborate statistical modeling.
authors.affiliation: Department of Psychology, University of Cambridge , Cambridge , UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Zhukovsky
authors.affiliation: Policy Research Group, Department of Psychology, University of Cambridge, Cambridge, UK; Department of Engineering, Engineering Design Centre, University of Cambridge, Cambridge, UK.
authors.forename: Kai
authors.initials: K
authors.lastname: Ruggeri
authors.affiliation: Policy Research Group, Department of Psychology, University of Cambridge, Cambridge, UK; Departamento de Psicología Social y Metodología, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Garcia-Garzon
authors.affiliation: Unit for Paediatric and Adolescent Psychiatry, Division of Paediatrics, University Medical Centre Maribor , Maribor , Slovenia.
authors.forename: Sara
authors.initials: S
authors.lastname: Plakolm
authors.affiliation: Clinical Psychology with Focus on Psychotherapy Research, Department of Psychology, University of Zurich , Zürich , Switzerland.
authors.forename: Elisa
authors.initials: E
authors.lastname: Haller
authors.affiliation: Mind, Brain, and Behavior Research Center, University of Granada , Granada , Spain.
authors.forename: Dafina
authors.initials: D
authors.lastname: Petrova
authors.affiliation: Department of Psychology, University of Cambridge, Cambridge, UK; The Psychometrics Centre, University of Cambridge, Cambridge, UK.
authors.forename: Vaishali
authors.initials: V
authors.lastname: Mahalingam
authors.affiliation: The Psychometrics Centre, University of Cambridge, Cambridge, UK; Quantitative Methods and Predictive Psychometrics Laboratory, Institute of Psychology, Federal University of Bahia, Salvador, Brazil.
authors.forename: Igor G
authors.initials: IG
authors.lastname: Menezes
keywords: cost; decision-making; destination; factors; medical travel; public health policy; quality
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