Factoren die de keuze van patiënten voor zorgaanbieders in europese en noord-amerikaanse landen bepalen


  • Anne Els, van




Introduction: Since the introduction of a market oriented structure in public health care patients are expected to make informed choices between health care providers. However, it is still unclear what patients base their decisions on. The objective of this literature study is to identify the personal, healthcare provider-related, logistic and financial factors which determine the patients’ choice for certain healthcare providers. More specifically, only determinants of choice for surgical hospital care in European and North-American countries are studied. Method: Articles were mainly derived from the Pubmed, Medline and Google Scholar databases. Search terms used were patient choice, provider, physician and hospital. Furthermore, 3 additional articles were provided by the supervisors and 8 articles were included by backwards referencing. After inclusion, the articles were analyzed by the simple approach. Results: 27 articles were taken into account for analyses. Personal factors that influence the patient´s choice for a certain provider are age, race, medical condition, educational level, earlier experiences and the advice of people in the social network of patients. Furthermore, provider related factors which often came forward were the expertise of staff, the number of services offered, reputation and the quality of care provided. Moreover, the type of organization and the size of hospitals have an impact on the choice. Important logistic aspects are the distance to the hospital, the waiting time before treatment and the travel options. Financial aspects which are considered in advance of choosing are the costs of treatment, the costs of travelling and the personal expenses. Conclusion: It can be concluded that many factors determine the patient’s choice. However, it is difficult to indicate the importance of all the factors found because often combinations of factors or interactions between factors determine the patient’s choice.


Roh CY, Moon MJ. Nearby, but not wanted? The bypassing of rural hospitals and policy implications for rural health care systems. Policy Studies Journal. 2005;33(3):377-94.

Varkevisser M, van der Geest SA. Why do patients bypass the nearest hospital? An empirical analysis for orthopaedic care and neurosurgery in the Netherlands. Eur J Health Econ. 2007;8(3):287-95.

Leister J, Stausberg J. Why do patients select a hospital? A conjoint analysis in two German hospitals. Journal of hospital marketing & public relations. 2007;17(2):13-31.

Roh CY, Lee KH. Hospital choice by rural medicare beneficiaries: does hospital ownership matter?--a Colorado case. J Health Hum Serv Adm. 2006;28(3):346-65.

Weir R, Feinberg JR, Capello WN. Factors Influencing Patient Choice of Hospital and Surgeon forTotal Hip or Knee Arthroplasty. Indiana Orthopaedic Journal. 2009:55.

Moscone F, Tosetti E, Vittadini G. Social interaction in patients’ hospital choice: evidence from Italy. Journal of the Royal Statistical Society: Series A (Statistics in Society). 2012;175(2):453-72.

Marang-van de Mheen P, Dijs-Elsinga J, Otten W, Versluijs M, Smeets H, Van der Made W, et al. The importance of experienced adverse outcomes on patients’ future choice of a hospital for surgery. Quality and Safety in Health Care. 2010;19(6):e16-e.

Wiedenhofer D, Keppler S. Free Hospital Choice In Switzerland–Patients’ Decision Criteria And Sources Of Information. Interdisciplinary Management Research. 2014;10:763-73.

Groenewoud A, Van Exel N, Bobinac A, Berg M, Huijsman R, Stolk E. What influences patients’ decisions when choosing a health care provider? Measuring preferences of patients with knee arthrosis, chronic depression or Alzheimer’s disease, using discrete choice experiments. Health services research. 2015;1475:6773.

Abraham J, Sick B, Anderson J, Berg A, Dehmer C, Tufano A. Selecting a provider: what factors influence patients’ decision making? Journal of Healthcare Management. 2011;56(2):99.

Dixon A, Robertson R, Appleby J, Burge P, Devlin NJ. Patient choice: how patients choose and how providers respond. London: The King’s Fund; 2010.

Victoor A, Delnoij DM, Friele RD, Rademakers JJ. Determinants of patient choice of healthcare providers: a scoping review. BMC health services research. 2012;12(1):272.

Escarce JJ, Kapur K. Do patients bypass rural hospitals?: Determinants of inpatient hospital choice in rural California. Journal of health care for the poor and underserved. 2009;20(3):625-44.

Burge P, Devlin N, Appleby J, Rohr C, Grant J. London Patient Choice Project Evaluation: A model of patients’ choices of hospital from stated and revealed preference choice data. Santa Monica: RAND Corporation; 2005.