PhD defence Y. (Yun) Liu

Primary care is essential health care which is to be made universally accessible to all individuals, and it should work as the central function and the core of building an integrated health system. In China, patients tend to bypass primary care and directly choose hospital care for common primary care services, resulting in compromised health outcomes for the population and unfavorable cost consequences. Hence, this dissertation aims  to explore and understand patients’ facility choice in China and, more specifically, the choice trade-off’s between primary care and higher-level facilities.

We let the following four research questions guide the research:
1.    What are the factors influencing patient’s health facility choice in China?
2.    What is the process of decision making in which these factors are considered in rural and urban China?
3.    Which facility attributes patients consider for first visits under different perceived disease severities, and what is the importance of each of these factors in rural and urban China?
4.    How do patient choice and visit time interact? How do the interventions to improve primary care facilities influence visit time and facility choice given  such interaction?

In answering these questions, we studied the quantitative effects of the factors that influence patients’ facility choice and the interaction between visit time and facility choice. We adopted multiple methods including systematic literature review, focus group interview, discrete choice experiments, and queueing analysis.

Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall or in the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.