Differences of patient empowerment between elective and contracted physicians in internal medicine in Austria: a quantitative content analysis

Abstract

Background Physicians impact and promote patient empowerment at various levels. Specialized ambulatory care is provided by either elective physicians or contracted physicians in Austria, which is unique internationally. The difference between the two groups is due to the contractual relationship with the social health insurance providers. This paper researches whether there are also differences in the promotion of patient empowerment between elective and contracted physicians in internal medicine in Vienna based on four dimensions of patient empowerment. Methods A quantitative content analysis analyzes the comments on DocFinder.at to identify the differences between the two groups. A deductive inductive approach based on the literature as the comments on DocFinder.at, led to a codebook with seven categories and forty-eight variables. In total of 1,153 comments collated, 912 have been relevant for further analysis. Differences between elective and contracted physicians became evident through defined dimensions of patient empowerment. Results Three out of four dimensions show clear differences between elective and contracted physicians. In health literacy, self-management and communication elective physicians exhibit more conducive conditions for patient empowerment compared to contracted physicians. In particular we observe differences in the communication-relevant factors and in the transfer of information. The time spent by physicians is a decisive factor in this context and is one of the key factors in choosing an elective over a contracted physician. Conclusions The findings serve suggest avenues for further research. Our results suggest that elective physicians tend to create more conducive framework conditions for patient empowerment compared to contracted physicians, however our findings are also limited by the method used so future research might address it with different approaches like surveys or experiments.