Reasons, perceived outcomes and characteristics of second-opinion seekers: Are there differences in private vs. public settings?

Liora Shmueli, Nadav Davidovitch, Joseph S. Pliskin, Igal Hekselman, Ran D. Balicer, Geva Greenfield

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: In most countries, patients can get a second opinion (SO) through public or private healthcare systems. There is lack of data on SO utilization in private vs. public settings. We aim to evaluate the characteristics of people seeking SOs in private vs. public settings, to evaluate their reasons for seeking a SO from a private physician and to compare the perceived outcomes of SOs given in a private system vs. a public system. Methods: A cross-sectional national telephone survey, using representative sample of the general Israeli population (n = 848, response rate = 62%). SO utilization was defined as seeking an additional clinical opinion from a specialist within the same specialty, on the same medical concern. We modeled SO utilization in a public system vs. a private system by patient characteristics using a multivariate logistic regression model. Results: 214 of 339 respondents who obtained a SO during the study period, did so in a private practice (63.1%). The main reason for seeking a SO from a private physician rather than a physician in the public system was the assumption that private physicians are more professional (45.7%). However, respondents who obtained a private SO were neither more satisfied from the SO (p = 0.45), nor felt improvement in their perceived clinical outcomes after the SO (p = 0.37). Low self-reported income group, immigrants (immigrated to Israel after 1989) and religious people tended to seek SOs from the public system more than others. Conclusions: The main reason for seeking a SO from private physicians was the assumption that they are more professional. However, there were no differences in satisfaction from the SO nor perceived clinical improvement. As most of SOs are sought in the private system, patient misconceptions about the private market superiority may lead to ineffective resource usage and increase inequalities in access to SOs. Ways to improve public services should be considered to reduce health inequalities.

Original languageEnglish
Article number238
JournalBMC Health Services Research
Volume19
Issue number1
DOIs
StatePublished - 23 Apr 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019 The Author(s).

Funding

We gratefully acknowledge the support (Grant No R/10/144) from the Israel National Institute for Health Policy and Health Services Research (NIHP). Funding was provided by a grant from the Israel National Institution for Health Policy and Health Service Research (NIHP) under grant number R/10/ 144. The Israel National Institution for Health Policy and Health Service Research had no role in the design and conduct of the study: collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. GG is a Research Fellow in Public Health and is supported by the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for NW London. This article presents independent research in part supported by the National Institute for Health Research (NIHR) under the Collaborations for Leadership in Applied Health Research and Care (CLAHRC) program for North West London. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

FundersFunder number
CLAHRC
National Institute for Health Research
Israel National Institute for Health Policy ResearchR/10/144
Collaboration for Leadership in Applied Health Research and Care - Greater Manchester

    Keywords

    • Health policy
    • Inequalities
    • Private system
    • Public system
    • Second opinion
    • Utilization

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