Factors associated with the hypertension outpatients' choice of healthcare providers in Korea

Abstract

This study was performed to identify hypertension outpatients' motivations in choosing healthcare providers i.e. tertiary hospitals, general hospitals (number of bed is more than or equal to 100), hospitals (number of bed is more than or equal to 30), and clinics for their care management and find the determinants influencing on their choice of healthcare providers. The unit of analysis was a hypertension outpatient visit (n=11,046). The X-2-test was performed to find the differences in choices of healthcare providers by patient characteristics. Additionally, ANOVA was employed to identify differences in out-of-pocket medical and medication costs by the type of provider. The 4 types of healthcare providers were then categorized into two levels (1 hospitals, 2=clinics), and finally, logistic regression analysis was performed to find factors influencing the patients' clinic visit for their care. Of the 11,046 cases, 82.9 percent of patients visited clinics for their care. The medical and medication out-of-pocket costs per case were the highest among the tertiary hospitals followed by general hospitals, hospitals, and clinics. Lower income and less education were associated with a higher frequency of clinic visits. The patients with National Health Insurance were more likely to visit clinics for their care than medicaid patients. Patients with any co-morbidity or disability were more likely to visit hospitals than patients without them. Patients taking any medical test were more likely to visit hospitals than those who were not. Patients with a medication prescription were more likely to visit clinics than those without. Not only for cost-containment to maintain a sound healthcare financing system, but also to reduce the burden of hypertension patients' out-of-pocket costs, policy-makers should pay more attention to encouraging chronic patients to visit clinics rather than hospitals for their care management.