Evidence map›Paper›PMID 40012077›Full record

ArticleHealth research policy and systems2025

Optimizing patient autonomy: a discrete choice experiment on preferences and disparities in healthcare provider selection.

Gideon Leibner, Shuli Brammli-Greenberg

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Article in Health research policy and systems, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

2 authors.

Gideon LeibnerThe Braun School of Public Health, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Shuli Brammli-GreenbergThe Braun School of Public Health, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. Shuli.brammli@mail.huji.ac.il.ORCID http://orcid.org/0000-0002-2803-6019

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2023, Israel introduced a legislative reform that, according to the Israeli Ministry of Health, aims to improve transparency and expand options for healthcare providers. This reform seeks to enhance patient choice, improve service quality and accessibility, foster competition and strengthen the public health system. The goals also include empowering patients to fully exercise their rights and make more informed healthcare decisions.

objectivesThis study explores public preferences regarding hospital choice before the 2023 reform, evaluates the relative importance of key hospital attributes influencing decision-making, assuming a baseline of high-quality care and analyses how these preferences vary across demographic and socio-economic groups.

methodsUtilizing a discrete choice experiment involving 2117 participants, this study quantifies preferences for different hospital attributes, including hospital type, geographical location, and appointment availability. The study design incorporates attributes identified through a literature review and expert interviews, optimized to estimate trade-offs between attribute levels.

resultsFindings indicate a strong preference for shorter waiting times and proximity to specialized services. Significant disparities emerge among respondents, particularly between those with public versus additional voluntary insurance coverage and across population groups (i.e. Arabs and Jews). A notable proportion of Arab respondents preferred the existing hospital choice regime over any suggested attribute combinations.

conclusionsWhile legislative reforms are designed to enhance patient involvement in decision-making, substantial gaps remain between policy intentions and actual public preferences. Although increased autonomy and choice empower patients, they can also introduce challenges, such as decision fatigue and the consumer paradox, potentially undermining reform effectiveness. Our findings underscore the need for more nuanced, patient-centred health policy approaches. Future research should focus on strategies that better address the diverse needs and preferences of the population, ultimately enhancing healthcare system efficiency and equity.

Indexed as

Choice BehaviorHealthcare DisparitiesHealth PersonnelHospitalsPatient ParticipationPatient PreferencePersonal AutonomyAdultAgedArabsDecision MakingFemaleHealth Care ReformHealth Services AccessibilityHumansIsraelHealth reformHealth services choicePublic preferencesSelective-contracting

Identifiers

PMID40012077
PMCPMC11866801

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.