Patient Mobility for Elective Secondary Health Care Services in Response to Patient Choice Policies: A Systematic Review. (August 2017)

• Record Type: Journal Article
• Authors: Aggarwal, Ajay; Lewis, Daniel; Mason, Malcolm; Sullivan, Richard; van der Meulen, Jan
• Is Part Of: Medical care research and review. Volume 74:Number 4(2017:Aug.)
• Page Start: 379
• Page End: 403
• Publication Date: 2017-08
• Subjects: patient choice -- provider competition -- patient mobility -- hospital bypassing; Medical care -- United States -- Periodicals; Medical care -- Periodicals; Medical care -- Research -- United States -- Periodicals; Medical care -- Research -- Periodicals; Medical economics -- United States -- Periodicals; Medical economics -- Periodicals; 362.10973
• DOI: 10.1177/1077558716654631
• Languages: English
• ISSNs: 1077-5587

Abstract

Our review establishes the empirical evidence for patient mobility for elective secondary care services in countries that allow patients to choose their health care provider. PubMed and Embase were searched for relevant articles between 1990 and 2015. Of 5, 994 titles/abstracts reviewed, 26 studies were included. The studies used three main methodological models to establish mobility. Variation in the extent of patient mobility was observed across the studies. Mobility was positively associated with lower waiting times, indicators of better service quality, and access to advanced technology. It was negatively associated with advanced age or lower socioeconomic backgrounds. From a policy perspective we demonstrate that a significant proportion of patients are prepared to travel beyond their nearest provider for elective services. As a consequence, some providers are likely to be "winners" and others "losers, " which could result in overall decreased provider capacity or inefficient utilization of existing services. Equity also remains a key concern.