Patients as healthcare consumers in the public and strongprivatestrong.pdfVIP

Bishop et al. BMC Health Services Research 2011, 11:129 /1472-6963/11/129 RESEARCH ARTICLE Open Access Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK Felicity L Bishop1*, Fiona Barlow1,2, Beverly Coghlan1,3, Philippa Lee1 and George T Lewith1 Abstract Background: The aim of this study was to compare patients’ experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS). Consumerism was used as a theoretical framework to explore patients’ experiences. Methods: Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture. Results: Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and “just added extras: physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete inform