Choosing a GP - Experiences from the implementation of a list patient system in Norway

When the list patient system was introduced in Norway in 2001, the population was requested to choose a general practitioner (GP). Prior to the reform they were asked to rank their three most preferred GPs in an entry form. Information from the entry form was input for the algorithm1 that allocated GPs and inhabitants. The first aim of this paper is to explore what factors the Norwegian population considered to be important when they filled in the entry form and selected their preferred GP. We question whether they considered the GP’s medical skill, practical matters or continuity of care, or if they felt that the opportunity set restricted their possibilities to make a choice. The second aim of the study is to identify factors of importance to the outcome of the allocation process. Important questions are whether the whole population participates in the list patient system, what factors characterize those who refuse to participate, and what factors that determine whether individuals’ are allocated to their first-choice doctor. The third aim of the study is to identify factors of importance as to whether people express satisfaction with their GP after the reform. We question whether predisposing factors, prior illness or individuals’ preferences matter, whether characteristics of the personal GP are of importance and finally, whether the outcome of the allocation process and the organization of the local health care market influence individuals’ satisfaction with their GP.