Factors that influence the choice of seeking treatment at polyclinics

Chow WL, Wang VW, Low YS, Tse DWL, Lim JFY
Correspondence: Dr Chow Wai Leng, chow.wai.leng@singhealth.com.sg

ABSTRACT
Introduction Patients in Singapore can choose their primary care provider on a per-episode basis and pay out-ofpocket for services rendered. The infrastructure of subsidised and private primary care sector facilities differs. Onsite  ancillary services are available in subsidised facilities, allowing for convenience of routine investigations, while private  clinics are usually standalone practices. This study sought to examine the factors influencing patients’ choice of polyclinic.
Methods This was a cross-sectional survey of a convenient sample of 484 random patients who sought treatment at a  polyclinic located in a new housing estate from 24–27 June 2008. 
Results The response rate was 85.4% (n = 409). 38.1% of the patients were male. Mean age was 36.2 years. Only 13.8%  had a regular private family physician, while 37.3% were followed up at polyclinics. Patients on regular polyclinic followup were more likely to be older (p < 0.001), unemployed, retirees or housewives (p < 0.001) and were seeking treatment  for chronic diseases (p < 0.001). Geographical convenience (p = 0.002), low cost of consultation (p = 0.024), and onsite laboratory (p = 0.001) and imaging services (p = 0.018) significantly influenced those on regular polyclinic follow-up to attend the polyclinic.
Conclusion Affordability, convenience of travel and onsite laboratory facilities influence patients’ choice of seeking treatment at polyclinics. Further research examining whether the overall convenience of onsite ancillary services influences patients’ choice of primary care provider would be useful in redesigning private primary care infrastructure to enhance patient convenience and encourage more patients to have a regular private family physician.

Keywords: choice, influencing factors, out-of-pocket payments, primary care
Singapore Med J 2012; 53(2): 109–115