Private and public primary healthcare provider listing according to self-reported illness burden after the free choice reform: a cross-sectional study in southern Sweden

Abstract

Aims:

To investigate differences between respondents’ self-reported registration with public and private primary healthcare (PHC) providers according to self-reported illness burden in the early phase of the free choice reform.

Methods:

The Public Health Survey undertaken in Scania, southernmost Sweden, in 2012 was a population-based study of a stratified random sample of 18–80-year olds that elicited a 51.7% participation rate. The survey included data on PHC provider type, age, sex, marital status, socioeconomic status, country of birth, and self-reported illness burden measured as poor psychological health (via the 12-item General Health Questionnaire; GHQ12), poor self-rated health, and self-reported chronic illness. Poor psychological health (GHQ12), poor self-rated health, and self-reported chronic illness were analyzed together in logistic regression models with public versus private PHC provider as the dichotomous outcome.

Results:

In 2012, 55.2% reported being listed with a public PHC provider, 26.1% a private PHC provider, and 18.6% did not know what type their provider was. In the final multi-adjusted logistic regression model, the odds ratios of reporting private PHC provider were 1.01 (0.91–1.13) among respondents with poor psychological health, 0.98 (0.89–1.07) among respondents with poor self-rated health, and a non-significant 1.09 (1.00–1.20) among respondents with self-reported chronic illness.

Conclusions:

After adjusting for relevant confounders, no statistically significant differences were found between private and public PHC providers, according to self-reported illness burden in Scania in 2012.