Abstract
This study aimed to determine the factors influencing patients’ choice of physician at the first visit through database analysis of a tertiary hospital in South Korea. We collected data on the first treatments performed by physicians who had treated patients for at least 3 consecutive years over 10 years (from 2003 to 2012) from the database of Seoul National University’s affiliated tertiary hospital. Ultimately, we obtained data on 524,012 first treatments of 319,004 patients performed by 115 physicians. Variables including physicians’ age and medical school and patients’ age were evaluated as influencing factors for the number of first treatments performed by each physician in each year using a Poisson regression through generalized estimating equations with a log link. The number of first treatments decreased over the study period. Notably, the relative risk for first treatments was lower among older physicians than among younger physicians (relative risk 0.96; 95% confidence interval 0.95 to 0.98). Physicians graduating from Seoul National University (SNU) also had a higher risk for performing first treatments than did those not from SNU (relative risk 1.58; 95% confidence interval 1.18 to 2.10). Finally, relative risk was also higher among older patients than among younger patients (relative risk 1.03; 95% confidence interval 1.01 to 1.04). This study systematically demonstrated that physicians’ age, whether the physician graduated from the highest-quality university, and patients’ age all related to patients’ choice of physician at the first visit in a tertiary university hospital. These findings might be due to Korean cultural factors.
Highlights
When patients must select a care provider due to new health events, many rely passively on primary physician referral, distance to the care provider, or previous experiences
A small number of patients (10–13%) tend to actively choose a care provider, and these may include highly educated and young patients, patients with high income, and patients having a bad relationship with their previous provider, various studies have reported conflicting results [1,2]
The proportion of physicians graduating from Seoul National University (SNU) was much larger than that of physicians not from SNU, and this proportion increased further at first treatment compared to the baseline
Summary
When patients must select a care provider due to new health events, many rely passively on primary physician referral, distance to the care provider, or previous experiences. Patients’ choices of medical care are believed to be determined by complex interaction between the characteristics of the patient and provider. Patients aim to obtain highquality care while minimizing costs. Because they often lack information in this regard, most patients cannot make a completely rational choice. They tend to choose their physician based on providers’ characteristics from among many in the hospital that treat the same condition [1]
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