PRASENTED BYKiranjeet kumar jagmohan khandelwal Alok Ranjan Anurag Srivastva Raj kishore

OVERVIEW OF CASE
Primary child health care is provided by pediatricians, family physicians(FPs), general practitioners and family mid level practitioners(physician, assistants and nurse practitioners) . Pediatricians are estimated to currently cater to about 55 to 60 percent of market Nonphysicians provide to barely 5% . FP and GPs are estimated to devote 50 to 30% of there practices to child health care By 1990 it was estimated that one out of every 4 general Pediatricians could be surplus, though there could be some shortage in sub specialties .

MATHOD OF SURVEY
Open ended interview ware conducted with 70 mothers waiting to see one of seven pediatricians in privet practices. They ware asked how they first became aware of their childs health care provider(HCP), how they investigated their alternatives, what factor ware important in their decision making , and whether they had ever left of provider, and if so the reason for the same. the responses from these preliminary interview ware used to develop a close ended questionnaire which was administered to a mail panel of 750 families in the state of arkanasas of the sample 630 (84%) of the households returned the questionnaire out of these 244 household indicated that they had children less than 18 yrs of age in the home .

MATHOD OF SURVEY
229 (94%) of these families identified a regular child health care provider , 99 pediatrician , 119 a generalist (GP or FP) and 11 identified other providers. The results presented are based on the data collected from these 229 families In all cases the questionnaire ware completed by parents who ware instructed to answer the questions relating to health care with specific reference to the youngest child living at home with them.

RESULT OF SURVEY
1. Provider loyalty

 60% of the respondents reported using the same HCP for more than four years.  35% of the total respondents reported using the same HCP for more than 8 years.  The data further show that 50% of those using a generalist have been using the same provider for over 8 years.

RESULT OF SURVEY
2. Profile of the choice set

 Responding ware asked the number of HCP seriously consider before they selected their present provider.  34% of all respondents did not consider any alternative providers.  32% consider just one other alternative providers.

 The rest consider three or more alternative provider.

RESULT OF SURVEY
3. Sources of information in search process
 Friends and neighbors.  Other family members.  Other physicians.  Encounters as a patient.  Encounters other than as a patients.  Phone directory.  Government agencies, and  Local medical societies.

RESULT OF SURVEY
4. Demographic Differences
 Two third of mail parents using a pediatrician were 36 year or less in age, while among those going to a generalist, two thirds where over 36 years.  82% of family going to a pediatrician mention that the youngest child was age 10 years or less.  An important finding was that there was no significant difference in annual house hold income between the two goods.  One recent survey reports that pediatricians charge on an average about 20% more than GPs/FPs.

RESULT OF SURVEY
5. Factors considered as important in selection of HCP
 Recommendation of friend or neighbor.  Personality of providers.  Whether provider explains properly.  Can get appointments quickly.  Recommendation on other family members.  Providers office hours.  More than one physicians in practice.  Convenient location.  Age of provider.

RESULT OF SURVEY
6. Causes of dissatisfaction
 Doctor not interested in childs behaviors.  No concern for child.  Child not getting better.  Doctor incompetent.  Office too far away.  Found another MD more convenient.  Staff were rude.  No concern for me.

Questions for audience

1. How extensive is the health care search process amount these consumers ? 2. How important does opinion leadership appear to be in these decisions? 3. What degree of consumer involvement exists among these respondents? Is the nature of this involvement enduring, situational, or some other type ?

Questions for audience

4. Does the level of consumer involvement characterized in these situation seem to match the extent of information search? 5. How would you account for differing age groups choosing different types of health care providers?