Behavioral patterns in accessing the healthcare system in Slovenia: a pilot survey

Abstract Background Access to healthcare in the context of workforce shortages and financial constraints is a policy priority in many countries, including Slovenia. This study examined patients’ behaviors in response to access constraints and their implications for healthcare inequalities. Methods We conducted a national cross-sectional survey using the computer-assisted web interviewing approach targeting the general population (N = 1,000 adults, mean age = 48,0 years, SD = 15,6, range = 18-75). A new questionnaire was developed and cognitively tested to capture the population behavior in healthcare utilization in the Slovenian healthcare system. Results Among survey respondents, 71.7% had at least one chronic condition and 80.3% had been in touch with their general practitioner in the previous year. 22.1% of respondents indicated that they utilized healthcare services outside the public healthcare system for types of services that are covered by compulsory health insurance. The main reasons for opting to avoid the public healthcare system were: long waiting times (68.0%), quality concerns (17.0%), easier scheduling (14.6%), and loyalty to specific healthcare providers (15.1%). These respondents paid for the services mostly out of pocket (74.4%%) or by using supplementary health insurance (18.3 %). There were no significant differences in use of supplementary health insurance or use of private services when also covered by compulsory health insurance, when comparing respondents reporting financial difficulties with those who did not report them. Conclusions Survey respondents relatively often use privately provided healthcare services, even when they could receive them in the public system, most often because of long waiting times. Our survey did not indicate clear differences in the use of those services or supplementary health insurance that might provide them, based on the financial standing of the respondents. Key messages • Patients in Slovenia often use health services outside the public healthcare system, even when the services are covered by compulsory health insurance in the public healthcare system. • The main reason for using healthcare services outside the public healthcare system are long waiting times.