Effects of patients’ motives in choosing a provider on determining the type of medical institution

BACKGROUND: Primary care is relatively weak in the Republic of Korea. As the referral system is not well established, patients can freely choose from among clinics, hospitals, and tertiary hospitals. This study was conducted to determine the factors influencing patients’ choice of providers. METHODS: A survey was conducted of 999 Korean adults aged 19–59 years. An exploratory factor analysis was performed on nine factors influencing their motives in choosing a medical provider. The factors derived from this analysis and the types of medical institutions were used as the independent and dependent variables, respectively, in logistic regression analysis. Adjustments were made for region, gender, age, educational level, income, type of insurance, and chronic diseases. RESULTS: The results showed that patients preferred clinics when considering the importance of accessibility, staff kindness, and patient-centeredness; they preferred hospitals when considering cleanliness; and tertiary hospitals when considering the reputation and structural factors. When considering structural factors, clinics and hospitals were less preferred; however tertiary hospitals were less preferred when considering accessibility, staff kindness, and patient-centeredness. CONCLUSION: It is necessary to provide more accessible and patient-centered services in order to strengthen the primary health care role of clinics. In addition, efforts are needed to improve the quality of health care of tertiary hospitals in order to meet patient expectations.