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. 2019 Jan-Dec:56:46958019865434.
doi: 10.1177/0046958019865434.

Identifying Determinants for Traveled Distance and Bypassing in Outpatient Care: A Scoping Review

Nicole Zander  1 , Jessica Dukart  1 , Neeltje van den Berg  2 , Jobst Augustin  1
Affiliations

Identifying Determinants for Traveled Distance and Bypassing in Outpatient Care: A Scoping Review

Nicole Zander et al. Inquiry. 2019 Jan-Dec.

Abstract

The outpatient sector represents a growing share of health care. This review examines how patients choose their physician for continuous outpatient care and why they are willing to bypass the nearest physician. It was conducted according to the PRISMA extension for scoping reviews (PRISMA-ScR). Three databases (PubMed/Medline, ScienceDirect, and Ovid Medline) were searched, focusing on articles in which distance influenced the choice of physician. In all, 1,308 articles were accessed, and 17 selected for final review. First, we extracted methods for assessing distance traveled and bypassing. Second, we identified determinants that directly influence the traveled distance and transferred all into a conceptual framework. The center of this framework is the individual "willingness-to-go", which reflects the willingness of patients to accept additional distances. Our findings can support studies on patient mobility and physician choice, which are essential for examining both the distribution and use of medical services, as well as for adequate need related planning.

Keywords: bypassing; distance; health services research; mobility; outpatient; physician choice; review.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Structure of the search string.
Figure 2.
Figure 2.
Flow chart of study selection.
Figure 3.
Figure 3.
Factors determining willingness-to-go.
See this image and copyright information in PMC

References

    1. Barros PP, Brouwer WBF, Thomson S, Varkevisser M. Competition among health care providers: helpful or harmful? Eur J Health Econ. 2016;17(3):229-233. doi:10.1007/s10198-015-0736-3. - DOI - PMC - PubMed
    1. Scanlon DP, Swaminathan S, Lee W, Chernew M. Does competition improve health care quality? Health Serv Res. 2008;43(6):1931-1951. doi:10.1111/j.1475-6773.2008.00899.x. - DOI - PMC - PubMed
    1. Vrangbaek K, Robertson R, Winblad U, van de Bovenkamp H, Dixon A. Choice policies in Northern European health systems. Health Econ Policy Law. 2012;7(1):47-71. doi:10.1017/S1744133111000302. - DOI - PubMed
    1. Dranove D, Satterthwaite MA. The industrial organization of health care markets. In:Culyer AJ, Newhouse JP. eds. Handbook of Health Economics. Vol. 20, 1st ed. [Reprinted]. Amsterdam, The Netherlands: Elsevier; 2000:1034-1139.
    1. Hirschman AO. Exit, Voice, and Loyalty: responses to Decline in Firms, Organizations, and States. Cambridge, MA: Harvard University Press; 1970.

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