TY - JOUR
T1 - What motivates physicians to propose private services in a mixed private-public healthcare system? A mixed methods study
AU - Michael, Tal
AU - Filc, Dani
AU - Davidovitch, Nadav
N1 - Funding Information:
This research was funded by the Israel National Institute for Health Policy Research [grant number 2015/140]. The funding source had no involvement in the study design, analysis or interpretation of the data.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Background: Implementation of private elements, including private insurances, in public healthcare system is now common in many countries, and its impacts have been well studied. Little, however, is known about the motives leading physicians, major role players in the system, to promote the usage of private services. The aim of this study was to explore the various motives leading physicians within public systems to propose private services to their patients, while examining the possible associations to their specialty and level of commitment. Methods: A total of 197 physicians from specialisms loaded more to private/public sectors participated in a cross-sectional telephone survey regarding their attitudes on their practices, private insurances, access to healthcare, and job satisfaction. The association between the likert scale questions to their recommendation to purchase private insurance, and the commitment they felt towards patients were analyzed using Generalized Estimating Equations (GEE) as well as logistic regression models. Results: Our findings suggest physicians engaged in dual practice are less likely to promote private insurances among their patients if they are satisfied with their public job (OR = 0.92, 95%CI 0.89,0.94). Physicians perceived private insurances as beneficial for patients, were found likely to promote them (OR = 1.65, %95CI 1.16, 2.35). The commitment physicians felt toward patients who paid out-of-pocket money was associated to their sense of being trusted and valued (OR = 1.99, 95%CI 1.33, 2.88; OR = 1.5, 95%CI 1.05, 2.13 respectively). Conclusion: This study suggests a deeper understanding of physicians’ daily experience of the private-public mix and it’s consequences, and could provide a platform for future studies. Further studies on physician’s role in health privatization processes are needed, and could aid policymakers in their efforts to strengthen healthcare systems around the world.
AB - Background: Implementation of private elements, including private insurances, in public healthcare system is now common in many countries, and its impacts have been well studied. Little, however, is known about the motives leading physicians, major role players in the system, to promote the usage of private services. The aim of this study was to explore the various motives leading physicians within public systems to propose private services to their patients, while examining the possible associations to their specialty and level of commitment. Methods: A total of 197 physicians from specialisms loaded more to private/public sectors participated in a cross-sectional telephone survey regarding their attitudes on their practices, private insurances, access to healthcare, and job satisfaction. The association between the likert scale questions to their recommendation to purchase private insurance, and the commitment they felt towards patients were analyzed using Generalized Estimating Equations (GEE) as well as logistic regression models. Results: Our findings suggest physicians engaged in dual practice are less likely to promote private insurances among their patients if they are satisfied with their public job (OR = 0.92, 95%CI 0.89,0.94). Physicians perceived private insurances as beneficial for patients, were found likely to promote them (OR = 1.65, %95CI 1.16, 2.35). The commitment physicians felt toward patients who paid out-of-pocket money was associated to their sense of being trusted and valued (OR = 1.99, 95%CI 1.33, 2.88; OR = 1.5, 95%CI 1.05, 2.13 respectively). Conclusion: This study suggests a deeper understanding of physicians’ daily experience of the private-public mix and it’s consequences, and could provide a platform for future studies. Further studies on physician’s role in health privatization processes are needed, and could aid policymakers in their efforts to strengthen healthcare systems around the world.
KW - Healthcare
KW - Mixed methods
KW - Private insurance
KW - Private public mix
KW - Privatization
UR - http://www.scopus.com/inward/record.url?scp=85122457017&partnerID=8YFLogxK
U2 - 10.1186/s12913-022-07474-9
DO - 10.1186/s12913-022-07474-9
M3 - Article
C2 - 35012548
AN - SCOPUS:85122457017
SN - 1472-6963
VL - 22
JO - BMC Health Services Research
JF - BMC Health Services Research
IS - 1
M1 - 51
ER -
