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Travel distance decisive factor when choosing a hospital

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20 March 2023
When people are asked what is important to them when choosing a healthcare provider, they usually say they prioritize quality, but in practice, distance to the hospital proves decisive. What explains that the preference of patients is not decisive for their actual choice? According to healthcare researcher Benjamin Salampessy, it has everything to do with the Dutch healthcare system: "There is too little thought from the patient's perspective."

Salampessy investigated which hospital characteristics people claim to find important and how these correspond to the characteristics of the hospital they actually visited. He discovered that patients only find a small portion of the available quality information relevant when choosing a hospital. "Patients are overwhelmed with a lot of often complex information. They often do not know how much they have to pay for medication and their own risk, but they also have no idea which hospital offers the best quality of care. Information is made public, but due to the amount and complexity, this does not sufficiently help patients in making their choice," says Salampessy.

Patient need

One of the reasons for the introduction of the mandatory excess system (in Dutch: Eigen risico) by the government was to make people more aware of the price of healthcare and thus prevent them from visiting the doctor for every ache and pain. However, Salampessy emphasizes that there is an important downside to the current system of the excess: "The complexity of the Dutch system makes it difficult for people to make the right choice. Patients often do not know when they have to pay the excess and base their choice, among other things, on that. They first go to the general practitioner, who then refers them to the hospital. Some patients ultimately decide not to go, while the general practitioner had advised them to go. Patients then think, for example, that the costs will be too high. If the excess system was simpler and more transparent, more people would follow the general practitioner's advice," says Salampessy.

Let the general practitioner decide

One of Salampessy's recommendations to get patients to the best healthcare provider based on price and quality is to actively involve the referring general practitioner in the choice of a healthcare provider. "Quality information is often difficult for patients to understand. The general practitioner has medical knowledge and experience with the healthcare system and can make an appropriate choice. So, I recommend letting the general practitioner make the comparison between hospitals and choose the best hospital on behalf of the patient. This way, patients are directed to the best hospital based on the price-quality ratio, rather than the default hospital, which is often the nearest hospital. Additionally, many patients do not care about freedom of choice when choosing a hospital. They trust that healthcare in the Netherlands is of high quality and that the choice of hospital therefore makes little difference. Furthermore, patients want to know their diagnosis quickly and prefer to focus on that. Only once the diagnosis is established, do they want to think and participate in the treatment they receive," says Salampessy.

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