The introduction of choice in public services, and in health services more specifically, is part of a wider movement to introduce consumerism in health care. In this article in Administration and Society, Sofie Marien and I analyze how citizens perceive the availability of choice of primary care doctors in 22 European countries and the factors that influence their opinions using multilevel analyses and data from the European Social Survey (Round 2, 2004; 22 countries, N = 33,375). We distinguish between individual factors and structural or country-level factors. We find that perceptions of having enough choice are not influenced by the opportunity to freely choose primary care doctors, the density of doctors in a country, or the level of health expenditure. Instead, these perceptions are influenced by individual attributes, such as personal health circumstances, age, sex, location of residence (rural or urban), and level of satisfaction with the health system. Download from Administration & Society or as preprint from SSRN.
This chapter in the new ‘International Handbook of Public Administration and Governance‘, edited by Andrew Massey and Karen Johnston, draws on a large-scale survey of top European executives in central government in order to develop a more comprehensive and comparative picture of NPM reforms and their effects over the last five years. Focusing on a cross-section of nine EU countries plus Norway, the chapter presents findings on reform initiatives, relevance of different reform trends and their general success and impact within the case countries.