Decision support systems for choosing a primary health care provider in Sweden.

OBJECTIVE To evaluate how patients are supported with information and other forms of Web-based decision support for making an informed choice of a primary health care provider. METHODS The article is based on a comparative case study of recently developed tools provided by Web portals in Sweden (one national, three regional). The theoretical framework for analysis is the general calculation model, including the steps of isolating, examining, and ranking available options. RESULTS The provision of information and other forms of support is reasonable when it comes to isolating a particular alternative or presenting a general view of alternatives. As for examining and ranking, one regional system and one national system offer support based on information from patient surveys and waiting times, and one regional system offers support based on provider competencies. CONCLUSION One design alternative is to represent the opinions of patients about care centers, another is to represent the characteristics of care centers, and a third is to combine the two. The general calculation model is relevant as a framework for analysis from a practical as well as a theoretical viewpoint. PRACTICAL IMPLICATIONS The study provides practical examples of decision support for patient choice in primary health care.

[1]  Anja Dalgaard-Nielsen.  Looking to Europe , 2004 .

[2]  B. Bornstein,et al.  Choosing a doctor: an exploratory study of factors influencing patients' choice of a primary care doctor. , 2001, Journal of evaluation in clinical practice.

[3]  A. Rodday,et al.  Motivating Public Use of Physician-Level Performance Data , 2009, Medical care research and review : MCRR.

[4]  Ella E. Young,et al.  What Do People Think Is Important about Primary Healthcare? , 2008, Healthcare policy = Politiques de sante.

[5]  J. Haggerty,et al.  Choices for Change : The Path for Restructuring Primary Healthcare Services in Canada , 2003 .

[6]  J. Protheroe,et al.  Choosing, deciding, or participating: what do patients want in primary care? , 2008, The British journal of general practice : the journal of the Royal College of General Practitioners.

[7]  Gary Fanjiang,et al.  Providing Patients Web-based Data to Inform Physician Choice: If You Build It, Will They Come? , 2007, Journal of General Internal Medicine.

[8]  M. Callon,et al.  Economic markets as calculative collective devices , 2005 .

[9]  Henry W. W. Potts,et al.  Does Choose & Book fail to deliver the expected choice to patients? A survey of patients' experience of outpatient appointment booking , 2008, BMC Medical Informatics Decis. Mak..

[10]  J. Potter.  CONSUMERISM AND THE PUBLIC SECTOR: HOW WELL DOES THE COAT FIT? , 1988 .

[11]  Barbara Fasolo,et al.  Helping patients choose: how to improve the design of comparative scorecards of hospital quality. , 2010, Patient education and counseling.

[12]  Marije Bosch,et al.  Public Reporting in Health Care: How Do Consumers Use Quality-of-Care Information?: A Systematic Review , 2009, Medical care.

[13]  P. Bower,et al.  What Patients Want From Primary Care Consultations: A Discrete Choice Experiment to Identify Patients’ Priorities , 2008, The Annals of Family Medicine.

[14]  Yoshimichi Sato.  Rational choice theory , 2013 .

[15]  A. Deccache,et al.  From patient compliance to empowerment and consumer's choice: evolution or regression? An overview of patient education in French speaking European countries. , 2010, Patient education and counseling.

[16]  R. Fernandopulle,et al.  Health care policy , 1995 .

[17]  Trudy van der Weijden,et al.  Themes affecting health-care consumers' choice of a hospital for elective surgery when receiving web-based comparative consumer information. , 2010, Patient education and counseling.

[18]  I. Greener,et al.  Are the assumptions underlying patients choice realistic?: a review of the evidence. , 2007, British medical bulletin.

[19]  O. Damman.  Public reporting about healthcare users' experiences : The Consumer Quality Index , 2010 .

[20]  J. Scott.  Rational Choice Theory , 2007 .

[21]  Jonathon E. Mote,et al.  The laws of the markets , 2000 .

[22]  M. Callon,et al.  Peripheral Vision , 2005 .

[23]  Agneta Ranerup.  In What Ways Does Web Technology Support the Individual in Choice Reforms in Health Care? A Comparison among Norway, Denmark, and Sweden , 2008, Int. J. Heal. Inf. Syst. Informatics.

[24]  A. Ranerup.  Transforming patients to consumers: evaluating national healthcare portals , 2010 .

[25]  M. Callon.  Introduction: The Embeddedness of Economic Markets in Economics , 1998 .

[26]  R. Yin.  Case Study Research: Design and Methods , 1984 .

[27]  Peggy Gregory,et al.  Expectations and experiences of eHealth in primary care: A qualitative practice-based investigation , 2009, Int. J. Medical Informatics.

[28]  B. Burström.  Will Swedish healthcare reforms affect equity , 2009 .

[29]  H. Bastian.  Health literacy and patient information: developing the methodology for a national evidence-based health website. , 2008, Patient education and counseling.

[30]  A. Boyd,et al.  What benefits will choice bring to patients? Literature review and assessment of implications , 2008, Journal of health services research & policy.

[31]  G. Elwyn,et al.  Where is the theory? Evaluating the theoretical frameworks described in decision support technologies. , 2008, Patient education and counseling.

[32]  Margaret S. Archer,et al.  Rational Choice Theory: Resisting Colonisation , 2013 .