Assessment by the primary care physician of his influence on the patient's hospital choice and of his own ability to evaluate hospital quality

We report a mail survey (1993) of 677 primary care physicians employed by Israel's 4 sick funds of their influence on the patient's choice of hospital. In the light of the far-reaching changes currently taking place in the health system in Israel, factors considered by physicians in recommending a hospital were studied. About 50% reported having a high degree of influence over patient choice of hospital for elective procedures. Most reported themselves able to evaluate the quality of hospital care, especially results of clinical treatment (89%). Multivariate analysis revealed the physicians who reported a high degree of influence on patient hospital choice were men under the age of 65, independently employed by a smaller sick fund or by several sick funds. They considered themselves capable of evaluating hospital quality and were in regular professional contact with at least 1 hospital. The main factors considered in recommending a hospital were quality of its physicians and medical care, the way in which the hospital staff related to patients, and the level of equipment and technology available. Little importance was given to sick fund hospitalization policy. The survey findings had implications for primary care physicians, and for policymakers of the sick funds and the government.