Global Health Policy and Access to Care: Investigating Patient Choice on an International Level Using Social Media

Peter Zhukovsky; Kai Ruggeri; Eduardo Garcia-Garzon; Sara Plakolm; Elisa Haller; Dafina Petrova; Vaishali Mahalingam; Igor G Menezes

doi:10.3389/fpubh.2015.00284

Global Health Policy and Access to Care: Investigating Patient Choice on an International Level Using Social Media

Front Public Health. 2016 Jan 25:3:284. doi: 10.3389/fpubh.2015.00284. eCollection 2015.

Authors

Peter Zhukovsky¹, Kai Ruggeri², Eduardo Garcia-Garzon³, Sara Plakolm⁴, Elisa Haller⁵, Dafina Petrova⁶, Vaishali Mahalingam⁷, Igor G Menezes⁸

Affiliations

¹ Department of Psychology, University of Cambridge , Cambridge , UK.
² Policy Research Group, Department of Psychology, University of Cambridge, Cambridge, UK; Department of Engineering, Engineering Design Centre, University of Cambridge, Cambridge, UK.
³ 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.
⁴ Unit for Paediatric and Adolescent Psychiatry, Division of Paediatrics, University Medical Centre Maribor , Maribor , Slovenia.
⁵ Clinical Psychology with Focus on Psychotherapy Research, Department of Psychology, University of Zurich , Zürich , Switzerland.
⁶ Mind, Brain, and Behavior Research Center, University of Granada , Granada , Spain.
⁷ Department of Psychology, University of Cambridge, Cambridge, UK; The Psychometrics Centre, University of Cambridge, Cambridge, UK.
⁸ The Psychometrics Centre, University of Cambridge, Cambridge, UK; Quantitative Methods and Predictive Psychometrics Laboratory, Institute of Psychology, Federal University of Bahia, Salvador, Brazil.

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.

Objectives: 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.

Conclusion: 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.

Keywords: cost; decision-making; destination; factors; medical travel; public health policy; quality.