Pagpiling Pagpila: Understanding Patient Decision-Making through Rational Choice Theory in Choosing to Access Healthcare Services at the University of the Philippines-Philippine General Hospital (UP-PGH)

Abstract

This study explores the healthcare decision-making processes of patients at the University of the Philippines–Philippine General Hospital (UP-PGH) through the lens of Rational Choice Theory (RCT). As the country’s premier public hospital serving predominantly low-income Filipinos, UP-PGH provides a unique setting to examine how economic constraints, institutional inefficiencies, and personal agency intersect in shaping healthcare choices. Using thematic analysis of qualitative data, the research reveals that patients are not passive recipients of care but rational actors who assess trade-offs involving affordability, accessibility, time, and perceived quality of medical services. The findings highlight that while cost-efficiency is the primary motivator for seeking treatment at UP-PGH, patients also factor in institutional reputation and the competence of medical professionals. However, this choice often comes with hidden costs, including long queues, procedural delays, and physical and emotional strain. Despite these challenges, many patients remain loyal to the institution due to limited alternatives and deep-rooted trust in its services. By applying RCT, the study contributes to a deeper understanding of healthcare utilization in resource-constrained settings and calls for patient-centered reforms in policy and institutional practice. The research offers practical implications for patients, health institutions, policymakers, and scholars, advocating for a more equitable and responsive public healthcare system in the Philippines.