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.
