Patient Choice in Acute Care

Consumer healthcare information plays a critical role in informing patients who participate in or make healthcare decisions for themselves without direct supervision of a healthcare professional. One such example is the choice of facility for acute care, prototypically between a fully equipped emergency care department (ED) at a hospital and a more convenient but less capable urgent care (UC) or retail clinic. We model a strategic patient making this decision taking into account the limited medical information and convenience factors that affect the patient’s decision. This model is then used to inform the pricing decision made by the manager of the UC. We show that a separating equilibrium, in which all patients self-triaged as noncritical choose to go to the UC first, dominates pooling equilibria for moderate error rates in self-triage. We analyze the separating equilibrium to examine the effect of consumer health information (CHI) systems, and show that as the quality of the CHI decreases and the error rates go up, the co-pay for an UC decreases, the facility is smaller, and makes less profit. Keywords-consumer health information systems, classification error, Nash equilibrium, emergency room, urgent care