Patient Choice and Consumerism in Healthcare: Only a Mirage of Wishful Thinking?

Abstract

In many industrialized countries, healthcare systems are becoming increasingly competitive and patient-centered. Along with this development, the debate if, how and why patients act as sovereign consumers of healthcare services continues with sustained scholarly and societal interest. Regarding these aspects, the present essay summarizes essential aspects on the issue of patient choice for healthcare policy and research. First, the article elucidates the societal developments and political presumptions on which the concept of patient choice is built. These theoretical underpinnings are supplemented by an excursus covering the idiosyncrasies of the healthcare service encounter and lead to the introduction of a conceptual framework that illustrates relevant impact factors on patient’s ability to perform healthcare choices. Second, a brief summary of empirical findings provides current insights into evidence on patient choice. Here, the essay pays special attention to evidence on system-related outcomes, such as efficiency, and findings on the patient’s self-reflexion. Lastly, the essay closes with selected recommendations for health policy and academia.