Possibility or Utopia: Consumer Choice in Health Care: A Literature Review

Possibility or Utopia: Consumer Choice in Health Care: A Literature Review

Possibility or Utopia: Consumer Choice in Health Care: A Literature Review

Possibility or Utopia: Consumer Choice in Health Care: A Literature Review

Excerpt

This literature review, prepared for and funded by the Bertelsmann Stiftung, is part of a larger project “Consumer responsibility within the German health care system” (“Eigenverantwortung im deutschen Gesundheitswesen”), which RAND Europe is conducting jointly with the Institut für Gesundheits- und Sozialforschung (IGES), in consultation with the Bertelsmann Stiftung. The purpose of the project is to study politically feasible and financially responsible reforms of the German health care system with a focus on enhanced consumer responsibility and choice.

The literature review sets the context of the problem by reviewing the scientific literature on consumer choice in health care. It focuses on existing knowledge on this topic, both in Germany and abroad. The purpose of this literature review is to explore models of consumer choice and their effects, with an eye towards identifying options for further exploration in the project. The literature review tried to find evidence for effects of models of consumer choice on a number of outcome variables such as utilization, health status, satisfaction, equity and macro-economic effects to set the context for a reform discussion of the German system. The choice of the outcome variables was on one hand based on the increasing financing gap in the German Health Care System and on the other hand on the scope of the current German debate, which goes beyond cost-containment measures.

Since not all readers might be familiar with the characteristics of the German system, the report presents after outlining the theoretical framework of consumer choice and explaining the search methodology a description of the main features of the German Health Care system, with particular attention to the existing consumer choice options.

Then, the report defines and describes the concept of consumer choice and it collects evidence on models of consumer choice and experiences in other industrialized countries. The concluding chapter summarizes the results and discusses what the findings might mean for the German system.

The research method for the chapter on the German system was a search in the recent German literature of health economics and policy for the general features of consumer choice, cost containment and reforms in the German system.

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