The rise of private practice: a growing disquiet with public services?

A survey of 325 national patients attending six private clinics in Port Moresby was carried out to determine the characteristics of those using private medical services. Most patients were employed in professional or clerical occupations. A sizeable proportion of private patients were from low and moderate income categories and over 40% of those interviewed said that they had to borrow the money to pay for the consultation. Education level was positively associated with both attending a private practitioner as first choice of treatment and enrollment in a medical insurance scheme. 15% of patients were medically insured, and they were more likely to choose a private practitioner as first treatment choice. The most common reason given for choosing private sector health care was that it was quicker, but a notable proportion, particularly amongst those who had previously attended government health services for the same complaint, thought that private clinics had better doctors or gave better medicine. The findings are discussed and contrasted with those from other developing countries. Conclusions are drawn regarding the significance of these findings both in relation to the upgrading of the public health services and the regulation and monitoring of private health services.