The Social and Institutional Context of Decision-Making in the Case of Sickness

Illness has a major influence on people’s lives. Studying healthcare-seeking is therefore of vital importance. Patients’ decisions about healthcare fundamentally influence the performance of the overall healthcare system in terms of a population’s health, the quality of healthcare services, and the level of expenditures. Even though illness behaviour has been an intensively studied research topic over the past five decades, previous work has largely overlooked the embeddedness of these decisions in social and institutional contexts. We will present first insights from a project that aims at theoretically, methodologically, and empirically enhancing previous research. It contributes to the development of an integrative theoretical framework of illness behaviour and provides an important test case for institutional theories and the theory of frame selection.

For analyzing healthcare decision-making a new survey is constructed to collect data on the basis of 2,000 face-to-face interviews in Germany that will provide a unique data source covering the healthcare needs and the way these needs are managed. At the conference, we will provide first results from the survey. We will analyze people’s decision making when having a medical condition with a particular emphasis on the interpretation of symptoms and the utilization of healthcare, and generate information about the extent and variety of self-care strategies. Our paper covers how social networks and institutional features of the healthcare system influence the decision making of healthcare seeking.