Exploration of Factors that influence Demand for Private versus Public Inpatient Health Care Services in Semi-urban Communities

Background: Despite the theoretically universal coverage of the population by the public healthcare system, a high level of private health expenditure is reported in Greece. Payments are made by citizens who hope to achieve access to higher quality services than those provided by the public health sector. Aim: The investigation of factors influencing patient choice of hospital (public/private) in the regions of Central Greece and Thessaly and the evaluation of patient satisfaction with the hospital services chosen. Method: The study was conducted between May and July 2009 with a random sample of 141 participants aged over 18 years, discharged from one public and two private hospitals in the regions of Central Greece and Thessaly. Data collection was made using a questionnaire developed for the purposes of the study after extensive literature review. The statistical package SPSS 17.0 was used for statistical analysis, which included the Mann-Whitney test, x² test and logistic regression. The level of significance was considered to be p=0.05. Results: Females and patients from wealthy families preferred private hospital services. Individual savings had a significant positive effect on the decision to seek private hospital care. Of those treated in the public hospital, 70.4% reported that the main criterion for their choice was the low cost of hospitalization. Of the patients treated in private hospitals, 91.7% reported the intention to choose the same hospital in the event of another hospitalization, while the respective percentage for the patients admitted to the public hospital was 72.8%. Conclusions: Patients of higher socioeconomic status seek inpatient services from the private more often than from the public health sector. Patients hospitalized in private hospitals were more satisfied than those hospitalized in the public hospital.