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von Weinrich P, Kong Q, Liu Y. Would you zoom with your doctor? A discrete choice experiment to identify patient preferences for video and in-clinic consultations in German primary care. J Telemed Telecare 2024; 30:969-992. [PMID: 35915997 DOI: 10.1177/1357633x221111975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The popularity of video consultations in healthcare has accelerated during the COVID-19 pandemic. Despite increased availability and obvious benefits, many patients remain hesitant to use video consultations. This study investigates the relative importance of the consultation mode compared to other attributes in patients' appointment choices in Germany. METHODS A discrete choice experiment was conducted to examine the influence of appointment attributes on preferences for video over in-clinic consultations. A total of 350 participants were included in the analysis. RESULTS The level of continuity of care (46%) and the waiting time until the next available appointment (22%) were shown to have higher relative importance than consultation mode (18%) and other attributes. Participants with fewer data privacy concerns, higher technology proficiency, and more fear of COVID-19 tended to prefer video over in-clinic consultations. The predicted choice probability of a video over a typical in-clinic consultation and opting out increased from <1% to 40% when the video consultation was improved from the worst-case to the best-case scenario. CONCLUSION This study provides insight into the effect of the consultation mode on appointment choice at a time when telemedicine gains momentum. The results suggest that participants preferred in-clinic over video consultations. Policymakers and service providers should focus on increasing the level of continuity of care and decreasing the time until the next available appointment to prompt the adoption of video consultations. Although participants preferred to talk to their physician in person over consulting via video per se, the demand for video consultations can be increased significantly by improving the other appointment attributes of video consultations such as the level of continuity of care.
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Affiliation(s)
| | - Qingxia Kong
- Rotterdam School of Management, Erasmus University Rotterdam, The Netherlands
| | - Yun Liu
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, The Netherlands
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Yan N, Liu T, Xu Y, Fang X, Ma X, Yang M, Du J, Tan Z, Fan EW, Huang J, Akinwunmi B, Zhang CJP, Ming WK, Luo L. Healthcare preferences of the general Chinese population in the hierarchical medical system: A discrete choice experiment. Front Public Health 2022; 10:1044550. [PMID: 36466449 PMCID: PMC9713319 DOI: 10.3389/fpubh.2022.1044550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background Chinese health insurance system faces resource distribution challenges. A patient-centric approach allows decision-makers to be keenly aware of optimized medical resource allocation. Objective This study aims to use the discrete choice model to determine the main factors affecting the healthcare preferences of the general Chinese population and their weights in the three scenarios (chronic non-communicable diseases, acute infectious diseases, and major diseases). Methods This study firstly identified the key factors affecting people's healthcare preferences through literature review and qualitative interviews, and then designed the DCE questionnaire. An online questionnaire produced by Lighthouse Studio (version 9.9.1) software was distributed to voluntary respondents recruited from mainland China's entire population from January 2021 to June 2021. Participants were required to answer a total of 21 questions of three scenarios in the questionnaire. The multinomial logit model and latent class model were used to analyze the collected data. Results A total of 4,156 participants from mainland China were included in this study. The multinomial logit and latent class model analyses showed that medical insurance reimbursement is the most important attribute in all three disease scenarios. In the scenario of "non-communicable diseases," the attributes that participants valued were, from the most to the least, medical insurance reimbursement (45.0%), hospital-level (21.6%), distance (14.4%), cost (9.7%), waiting time (8.3%), and care provider (1.0%). As for willingness to pay (WTP), participants were willing to pay 204.5 yuan, or 1,743.8 yuan, to change from private hospitals or community hospitals to tertiary hospitals, respectively. Conclusions This study explores the healthcare preferences of Chinese residents from a new perspective, which can provide theoretical reference for the refinement of many disease medical reimbursement policies, such as developing different reimbursement ratios for various common diseases and realizing rational configuration of medical resources.
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Affiliation(s)
- Ni Yan
- Department of Medical Imaging Center, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Taoran Liu
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Science, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yuan Xu
- Department of Medical Imaging Center, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Xuanbi Fang
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Science, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Xinyang Ma
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Science, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Meng Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Jianhao Du
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Zijian Tan
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Er-wen Fan
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Jian Huang
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore,Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Babatunde Akinwunmi
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital Boston, Boston, MA, United States,Center for Genomic Medicine (CGM), Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston, MA, United States
| | - Casper J. P. Zhang
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Science, City University of Hong Kong, Hong Kong, Hong Kong SAR, China,*Correspondence: Wai-Kit Ming
| | - Liangping Luo
- Department of Medical Imaging Center, The First Affiliated Hospital, Jinan University, Guangzhou, China,Liangping Luo
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Williams G, Kinchin I. The application of discrete choice experiments eliciting young peoples' preferences for healthcare: a systematic literature review. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022:10.1007/s10198-022-01528-9. [PMID: 36169764 DOI: 10.1007/s10198-022-01528-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Understanding young people's preferences for healthcare is critical for reducing the negative effect of undesirable choices. This review aims to synthesise the evidence obtained from discrete choice experiments (DCEs) eliciting young people's preferences for healthcare interventions and service deliveries, specifically, to (1) examine the methodology, including a selection of attributes and levels, experimental design, estimation procedure and validity; (2) evaluate similarities, differences and rigour of designs to the general population DCEs; and, (3) compare the DCEs' application to the seven health priority areas defined by the World Health Organisation (WHO). METHODS A systematic review searching Medline, EconLIT, PsychINFO, Scopus, and Web of Science was performed up until May 2021. INCLUSION CRITERIA a DCE, eliciting young peoples' preferences (10-24 years of age), on a healthcare-related topic defined by WHO, peer-reviewed, full-text available in English. A bespoke checklist was used to assess the methodological quality of the included studies. RESULTS Eighteen DCE studies were included in the review, exploring interventions and service in sexual and reproductive health (n = 9; 50%), smoking cessation (n = 4; 22%), mental health (n = 1), nutrition (n = 1), unintentional injuries (n = 1), vaccination against severe but rare diseases (n = 1); and diabetes (n = 1). Compared to the general population, DCEs eliciting young people's preferences had a high proportion of monetary measures and a smaller number of choices per respondent with the overwhelming number of surveys using fractional factorial design. The majority of studies were of moderate quality (50-75% of the criteria met). CONCLUSIONS While identified DCEs touched on most health priority areas, the scope was limited. The conduct and reporting of DCEs with young people could be improved by including the state-of-the-art design, estimation procedures and analysis.
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Affiliation(s)
- Galina Williams
- School of Business, Accounting and Law, CQUniversity, Brisbane, Australia.
| | - Irina Kinchin
- Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
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Lim AH, Ng SW, Teh XR, Ong SM, Sivasampu S, Lim KK. Conjoint analyses of patients’ preferences for primary care: a systematic review. BMC PRIMARY CARE 2022; 23:234. [PMID: 36085032 PMCID: PMC9463739 DOI: 10.1186/s12875-022-01822-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/09/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
While patients’ preferences in primary care have been examined in numerous conjoint analyses, there has been little systematic effort to synthesise the findings. This review aimed to identify, to organise and to assess the strength of evidence for the attributes and factors associated with preference heterogeneity in conjoint analyses for primary care outpatient visits.
Methods
We searched five bibliographic databases (PubMed, Embase, PsycINFO, Econlit and Scopus) from inception until 15 December 2021, complemented by hand-searching. We included conjoint analyses for primary care outpatient visits. Two reviewers independently screened papers for inclusion and assessed the quality of all included studies using the checklist by ISPOR Task Force for Conjoint Analysis. We categorized the attributes of primary care based on Primary Care Monitoring System framework and factors based on Andersen’s Behavioural Model of Health Services Use. We then assessed the strength of evidence and direction of preference for the attributes of primary care, and factors affecting preference heterogeneity based on study quality and consistency in findings.
Results
Of 35 included studies, most (82.4%) were performed in high-income countries. Each study examined 3–8 attributes, mainly identified through literature reviews (n = 25). Only six examined visits for chronic conditions, with the rest on acute or non-specific / other conditions. Process attributes were more commonly examined than structure or outcome attributes. The three most commonly examined attributes were waiting time for appointment, out-of-pocket costs and ability to choose the providers they see. We identified 24/58 attributes with strong or moderate evidence of association with primary care uptake (e.g., various waiting times, out-of-pocket costs) and 4/43 factors with strong evidence of affecting preference heterogeneity (e.g., age, gender).
Conclusions
We found 35 conjoint analyses examining 58 attributes of primary care and 43 factors that potentially affect the preference of these attributes. The attributes and factors, stratified into evidence levels based on study quality and consistency, can guide the design of research or policies to improve patients’ uptake of primary care. We recommend future conjoint analyses to specify the types of visits and to define their attributes clearly, to facilitate consistent understanding among respondents and the design of interventions targeting them.
Word Count: 346/350 words.
Trial registration
On Open Science Framework: https://osf.io/m7ts9
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Wang W, Shi X, Jiang Y, Zhao H, Ong JJ, Wu D, Tucker JD, Terris-Prestholt F, Pan SW. Fear of nosocomial HIV infection may be a barrier to HIV testing among young college and university students in Suzhou, China. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1154-1160. [PMID: 32672506 DOI: 10.1080/07448481.2020.1786099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 05/13/2020] [Accepted: 06/12/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveHuman immunodeficiency virus (HIV) test uptake among college and university students in China remains suboptimal. This study aimed to identify and weigh the relative importance of HIV testing preferences among university students in China. Participants and methods: Qualitative interviews and discrete choice experiments (DCE) were used to identify and assess HIV testing preferences in hypothetical HIV testing scenarios. Study participants were sexually experienced university students in Suzhou city, China. Results: 198 participants completed 1980 DCE choice tasks. Risk of nosocomial HIV infection, accuracy, and distance were identified as the most important factors when deciding whether to test for HIV. Risk of nosocomial HIV infection was the most influential factor, accounting for 35.5% of the variation in participants' DCE stated choices. Conclusions: Fear of HIV nosocomial infection may be influencing HIV test preferences and possibly test uptake among university students in China. Interventions should consider addressing students' fear of HIV nosocomial infection as a potential barrier to HIV testing.
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Affiliation(s)
- Wanqi Wang
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Xiao Shi
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Yifan Jiang
- Department of Biological Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Hanrui Zhao
- Department of Biological Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Jason J Ong
- Central Clinical School, Monash University, Clayton, VIC, Australia
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Dan Wu
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Joseph D Tucker
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- School of Medicine, University of North Carolina at Chapel Hill, NC, USA
| | - Fern Terris-Prestholt
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Stephen W Pan
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
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Zhang J, Xu L, Qin W, Xu A. Do Residents and Healthcare Providers Differ in Preference for Family Doctor Contract Service? Evidence From a Discrete Choice Experiment. Front Public Health 2022; 10:800042. [PMID: 35223735 PMCID: PMC8866243 DOI: 10.3389/fpubh.2022.800042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/10/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Few are known on how and to what extent residents and healthcare providers have different preferences for family doctor contract service (FDCS). This study aimed to elicit and compare the residents' and healthcare providers' preferences for FDCS through a discrete choice experiment (DCE). Methods Residents and healthcare providers recruited for the DCE were asked to choose repeatedly between two hypothetical service plans, which differed in six attributes: cost, service package, service delivery, type of service, accessibility of medicine, and level of healthcare team. We use mixed logit regression models to determine preferences for potential attributes. Results A total of 2,159 residents and 729 healthcare providers completed valid DCE questionnaires. The mixed logit model results suggested that cost, service package, service delivery, type of service, accessibility of medicine, and level of healthcare team all had a significant impact on residents' and healthcare providers' preference. The level of healthcare team was the most important characteristic of FDCS to both residents and healthcare providers, followed by types of service. They have different preferences on the cost and way of service delivery. Conclusions This study provides new evidence on how and to what extent residents and healthcare providers have different preferences for FDCS by determining their perception of various service attributes. These findings suggested that the optimal design and improvement of FDCS plans should consider not only residents but also healthcare providers' preferences to maximize contract service uptake.
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Affiliation(s)
- Jiao Zhang
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Research Center for Major Health Risk Management and TCM Control Policy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, Cheeloo College of Medicine, School of Public Health, Shandong University, Jinan, China
- *Correspondence: Lingzhong Xu
| | - Wenzhe Qin
- Centre for Health Management and Policy Research, Cheeloo College of Medicine, School of Public Health, Shandong University, Jinan, China
| | - Aijun Xu
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Research Center for Major Health Risk Management and TCM Control Policy, Nanjing University of Chinese Medicine, Nanjing, China
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Yu X, Bao H, Shi J, Yuan X, Qian L, Feng Z, Geng J. Preferences for healthcare services among hypertension patients in China: a discrete choice experiment. BMJ Open 2021; 11:e053270. [PMID: 34876431 PMCID: PMC8655589 DOI: 10.1136/bmjopen-2021-053270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Our study aimed to support evidence-informed policy-making on patient-centred care by investigating preferences for healthcare services among hypertension patients. DESIGN We identified six attributes of healthcare services for a discrete choice experiment (DCE), and applied Bayesian-efficient design with blocking techniques to generate choice sets. After conducting the DCE, we used a mixed logit regression model to investigate patients' preferences for each attribute and analysed the heterogeneities in preferences. Estimates of willingness to pay were derived from regression coefficients. SETTING The DCE was conducted in Jiangsu province and Shanghai municipality in China. PARTICIPANTS Patients aged 18 years or older with a history of hypertension for at least 2 years and who took medications regularly were recruited. RESULTS Patients highly valued healthcare services that produced good treatment effects (β=4.502, p<0.001), followed by travel time to healthcare facilities within 1 hour (β=1.285, p<0.001), and the effective physician-patient communication (β=0.771, p<0.001). Continuity of care and minimal waiting time were also positive predictors (p<0.001). However, the out-of-pocket cost was a negative predictor of patients' choice (β=-0.168, p<0.001). Older adults, patients with good health-related quality of life, had comorbidities, and who were likely to visit secondary and tertiary hospitals cared more about favourable effects (p<0.05). Patients were willing to pay ¥2489 (95% CI ¥2013 to ¥2965) as long as the clinical benefits gained were substantial. CONCLUSIONS Our findings highlight the importance of effective, convenient, efficient, coordinated and patient-centred care for chronic diseases like hypertension. Policy-makers and healthcare providers are suggested to work on aligning the service provision with patients' preferences.
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Affiliation(s)
- Xiaolan Yu
- Department of Medical Informatics, Nantong University Medical School, Nantong, Jiangsu, China
| | - Haini Bao
- Department of Medical Informatics, Nantong University Medical School, Nantong, Jiangsu, China
| | - Jianwei Shi
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyu Yuan
- Department of Emergency Medicine, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Liangliang Qian
- Department of Family Health Services, Pujiang Community Health Service Center, Shanghai, China
| | - Zhe Feng
- Department of Medical Informatics, Nantong University Medical School, Nantong, Jiangsu, China
| | - Jinsong Geng
- Department of Medical Informatics, Nantong University Medical School, Nantong, Jiangsu, China
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Preferences of Iranians to select the emergency department physician at the time of service delivery. BMC Health Serv Res 2021; 21:1155. [PMID: 34696787 PMCID: PMC8547076 DOI: 10.1186/s12913-021-07183-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 10/18/2021] [Indexed: 01/20/2023] Open
Abstract
Background Understanding patient preferences in emergency departments (EDs) can provide useful information to enhance patient-centred care and improve patient’s experience in hospitals. This study sought to find evidence about patients’ preference for physicians when receiving services in EDs in Iran. Methods In this discrete choice experiment survey, 811 respondents completed the scenarios with 5 attributes, including type of physicians, price of services, time to receive services, physician work experience, and physician responsibility. Analyses were conducted for different social and economic groups as well as for the total population. Results This study showed that the willingness to pay (WTP) for being visited by a physician with a high sense of responsibility was 67.104US$. WTP for being visited by an emergency medicine specialist (EMS) was 22.148US$. WTP for receiving ED services 1 min earlier was 0.417US$ and for being visited by 1 year higher experienced physician was 0.866US$. WTP varied across different age groups, sex, health status, education, and income groups. Conclusion As the expertise and experience of providers are important factors in selecting physicians in EDs by the patients, providing this information to patients when they want to select their providers can promote patient-centred care. This information can decrease patients’ uncertainty in the selection of their services and improve their experience in hospitals.
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Norwood P, Correia I, Heidenreich S, Veiga P, Watson V. Is relational continuity of care as important to people as policy makers think? Preferences for continuity of care in primary care. Fam Pract 2021; 38:569-575. [PMID: 33738479 DOI: 10.1093/fampra/cmab010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In 2005, the Portuguese government launched a Primary Care reform that aimed to reinforce continuity of care. After a promising start, the reform is still incomplete and continuity has been compromised by the lack of General Practice doctors. OBJECTIVE This study evaluates public preferences for relational continuity of care alongside other attributes of Primary Care services in Portugal. METHODS We use a discrete choice experiment (DCE) to evaluate preferences and estimate the population's willingness to pay (WTP) for Primary Care attributes. We use a sequential, mixed-methods approach to develop a D-efficient fractional factorial design for the DCE. Five attributes were included in the DCE and there were 32 DCE choice sets. The data collection was conducted in 2014 and the final sample had 517 respondents. A random parameters multinomial logit was used to analyse the data. RESULTS We find that respondents value relational continuity of care, but that the current focus of the Portuguese NHS on relational continuity at the expense of other attributes is too simplistic. CONCLUSIONS Relational continuity should be part of a broader policy that emphasizes person-centred care and considers the preferences of patients for Primary Care attributes.
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Affiliation(s)
- Patricia Norwood
- Health Economics Research Unit, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Isabel Correia
- Escola de Economia e Gestão; JusGov - Universidade do Minho, Portugal
| | | | - Paula Veiga
- Escola de Economia e Gestão; JusGov - Universidade do Minho, Portugal
| | - Verity Watson
- Health Economics Research Unit, University of Aberdeen, Aberdeen AB25 2ZD, UK
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Corazza I, Pennucci F, De Rosis S. Promoting healthy eating habits among youth according to their preferences: Indications from a discrete choice experiment in Tuscany. Health Policy 2021; 125:947-955. [PMID: 33910762 DOI: 10.1016/j.healthpol.2021.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 03/24/2021] [Accepted: 03/28/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The incidence of overweight among youth in Western Countries requires the implementation of initiatives to promote healthy lifestyles. Although under particular conditions obesity is not preventable, drawing attention on factors affecting teenagers' preferences can ameliorate the efficacy of public interventions designed for health promotion. METHODS This study aims at eliciting teenagers' food preferences through a discrete choice experiment, conducted in Tuscany using a webAPP survey, with the participation of more than 4,700 teenagers. Respondents expressed their preferences for breakfast food based on three attributes: food quality, packaging and claim. The survey also collected information on respondents' socio-demographic characteristics, social influence and media use for food information. RESULTS Teenagers' preferences for healthy foods seem positively related with their own level of food literacy. The tendency of respondents to read labels and nutritional facts is positively associated with preferences for healthier foods. Peers' influence is not significant, while family influence has a positive impact on teenagers' healthy choices. Internet usage is associated with unhealthy choices with a healthy aspect. CONCLUSION The results can be useful in defining effective actions for the promotion of healthy behaviors among teenagers, either in communication and awareness campaigns or in education and activation initiatives, with respect to the reading and interpretation of nutritional facts and labels, the role of family and friends, and the use of media.
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Affiliation(s)
- Ilaria Corazza
- Health and Management Laboratory, Institute of Management, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, 56127 Pisa, PI, Italy.
| | - Francesca Pennucci
- Health and Management Laboratory, Institute of Management, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, 56127 Pisa, PI, Italy.
| | - Sabina De Rosis
- Health and Management Laboratory, Institute of Management, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, 56127 Pisa, PI, Italy.
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Physical Activity in the Daily Life of Adolescents: Factors Affecting Healthy Choices from a Discrete Choice Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186860. [PMID: 32961819 PMCID: PMC7559571 DOI: 10.3390/ijerph17186860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/07/2020] [Accepted: 09/15/2020] [Indexed: 12/31/2022]
Abstract
Physical activity improves peoples’ well-being and can help in preventing weight gain, obesity, and related non-communicable diseases. Promoting healthy behaviors in the daily travels and transport choices of adolescents is very important in early establishing healthy habits that imply routine physical activity. For designing and developing effective strategies, it is relevant to study adolescents’ preferences for physical activity and what factors in the social and environmental contexts affect their preferences. The paper investigates these aspects by means of a discrete choice experiment, using data from more than 4300 16–17 year-old adolescents in Italy. The results show that adolescents generally prefer walking for long time alone. However, females prefer cycling, while adolescents from lower educated families prefer motorized means of transport. Environmental factors affect the adolescents’ preferences: living nearby a green area is associated with more active and healthier choices in their short daily travels. Conversely, adolescents living closer to an industrial or high traffic area prefer to use motorized vehicles. Such findings have been discussed and policy implications presented, in order to support policymakers in designing cross-sectoral policies to promote healthy choices related to physical activity in adolescence.
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Peng Y, Jiang M, Shen X, Li X, Jia E, Xiong J. Preferences for Primary Healthcare Services Among Older Adults with Chronic Disease: A Discrete Choice Experiment. Patient Prefer Adherence 2020; 14:1625-1637. [PMID: 32982187 PMCID: PMC7505703 DOI: 10.2147/ppa.s265093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/13/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study was to quantify the relative importance of the preference heterogeneity of Chinese older adults with chronic disease for primary healthcare service (PHCS) in the hypothetical minor chronic disease scenario. PATIENTS AND METHODS A discrete choice experiment (DCE) was administered to the patients aged 60 and above with at least one chronic disease in China. Five DCE attributes were considered, including types of service, treatment options, out-of-pocket (OOP) cost per visit, distance to practice, and the seniority of medical practitioners. DCE data were analysed taking into account of potential preference heterogeneity using both a mixed logit model (MLM) and a latent class logit model (LCLM). RESULTS A total of 432 respondents consented to complete the questionnaires and 372 valid respondents were included in analysis. All attributes were significantly influencing respondents' PHCS choice except for the types of service. Significant preference heterogeneity was observed among respondents. Based on the preferred LCLM estimates, four latent classes were identified. The first class (28.8%) valued modern medicine service the most, the second class (17.8%) was dominated by distance to practice, the third class (29%) preferred all the attributes except the types of services and valued TCM service most, the fourth class (24.4%) paid more attention to the types of service. Education, gender, age, income, regions of residence, and status of the chronic condition were found to be associated with latent class memberships. CONCLUSION A better understanding of the relative importance of PHCS characteristics is a crucial step for the future policy implementations. The significant preference heterogeneity identified in this study highlights that effective policy interventions should be tailored to different patients' characteristics.
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Affiliation(s)
- Yingying Peng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Mingzhu Jiang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Xiao Shen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Xianglin Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Erping Jia
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Juyang Xiong
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
- Correspondence: Juyang Xiong School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of ChinaTel +86-13995629873 Email
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Manuli A, Maggio MG, De Cola M, Tripoli D, De Luca R, Calabrò RS. Towards improving primary care: Considerations on a Sicilian population-based survey. J Family Med Prim Care 2019; 8:3647-3652. [PMID: 31803667 PMCID: PMC6881924 DOI: 10.4103/jfmpc.jfmpc_455_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 06/19/2019] [Accepted: 09/25/2019] [Indexed: 11/04/2022] Open
Abstract
Background The healthcare reforms have led to the development of new primary care systems. These models allowed responding to people's needs but with problems in maintaining the relational continuity between the patient and therapist. Materials and Methods We performed a survey on 12 May 2018, in Messina (Sicily, Italy), during an informational event. Participants were invited to fill in a self-reported Italian questionnaire composed of 12 multiple-choice questions, specifically created by the authors. The tool included the assessment of the social status, the presence of chronic diseases, preference in health care, and evaluation of the services offered in the territory. Results As for the territorial services, we observed that the general practitioner (GP) was the most appreciated healthcare provider, followed by the nurse. Conclusions We believe that nurses can represent the most appropriate healthcare figure to potentiate GP's patient management in primary territorial care.
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Humphrey JM, Naanyu V, MacDonald KR, Wools-Kaloustian K, Zimet GD. Stated-preference research in HIV: A scoping review. PLoS One 2019; 14:e0224566. [PMID: 31665153 PMCID: PMC6821403 DOI: 10.1371/journal.pone.0224566] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 10/16/2019] [Indexed: 12/21/2022] Open
Abstract
Discrete choice experiments (DCE), conjoint analysis (CA), and best-worst scaling (BWS) are quantitative techniques for estimating consumer preferences for products or services. These methods are increasingly used in healthcare research, but their applications within the field of HIV research have not yet been described. The objective of this scoping review was to systematically map the extent and nature of published DCE, CA, and BWS studies in the field of HIV and identify priority areas where these methods can be used in the future. Online databases were searched to identify published HIV-related DCE, CA and BWS studies in any country and year as the primary outcome. After screening 1,496 citations, 57 studies were identified that were conducted in 26 countries from 2000-2017. The frequency of published studies increased over time and covered HIV themes relating to prevention (n = 25), counselling and testing (n = 10), service delivery (n = 10), and antiretroviral therapy (n = 12). Most studies were DCEs (63%) followed by CA (37%) and BWS (4%). The median [IQR] sample size was 288 [138-496] participants, and 74% of studies used primary qualitative data to develop attributes. Only 30% of studies were conducted in sub-Saharan Africa where the burden of HIV is highest. Moreover, few studies surveyed key populations including men who have sex with men, transgender people, pregnant and postpartum women, adolescents, and people who inject drugs. These populations represent priorities for future stated-preference research. This scoping review can help researchers, policy makers, program implementers, and health economists to better understand the various applications of stated-preference research methods in the field of HIV.
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Affiliation(s)
- John M. Humphrey
- Department of Medicine, Indiana University, Indianapolis, Indiana, United States of America
| | - Violet Naanyu
- Department of Behavioral Sciences, Moi University, Eldoret, Uasin Gishu County, Kenya
- AMPATH Program, Eldoret, Uasin Gishu County, Kenya
| | - Katherine R. MacDonald
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, United States of America
| | - Kara Wools-Kaloustian
- Department of Medicine, Indiana University, Indianapolis, Indiana, United States of America
| | - Gregory D. Zimet
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, United States of America
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Chudner I, Drach-Zahavy A, Karkabi K. Choosing Video Instead of In-Clinic Consultations in Primary Care in Israel: Discrete Choice Experiment Among Key Stakeholders-Patients, Primary Care Physicians, and Policy Makers. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:1187-1196. [PMID: 31563262 DOI: 10.1016/j.jval.2019.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 04/27/2019] [Accepted: 05/01/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Despite its innovative benefits, the adoption of video consultations (VCs) in primary care settings is complex and slow. OBJECTIVES To quantify the preferences of key stakeholders in Israel's primary care-patients, primary care practitioners, and policy makers-regarding VCs compared with traditional in-clinic consultations (ICC) in nonurgent conditions. METHODS Discrete choice experiment surveys were completed by 508 patients, 311 physicians, and 141 policy makers. These consisted of 12 choice tasks of 2 labeled alternatives (VC or ICC), with the 4 attributes most relevant to each stakeholder group. A random effects logit model analysis was used to estimate stakeholders' preferences. RESULTS All 4 experiments' attributes were significantly important in choosing VC versus ICC for the patient group and the physician group. Three out of 4 attributes were significantly important to policy makers. Differences and similarities between stakeholders were identified in attribute rank order, trade-offs, and VC uptake probabilities. Policy makers' VC uptake rate was 86%. Patients' preferences suggested that 68% of ICCs could be replaced by VCs. Physicians' VC uptake was 30% in cases in which the consultation purpose was to diagnose and provide treatment and 48% in cases in which the consultation purpose was follow-up. CONCLUSIONS Our findings show key stakeholders' preferences about VC integration, to be considered when these systems are introduced into primary care and optimize the implementation process. Although there is a stronger preference for ICC among physicians and patients, alternative combinations of attribute levels might be used to compensate and reconfigure a more preferred VC service.
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Affiliation(s)
- Irit Chudner
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
| | | | - Khaled Karkabi
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Family Medicine, Clalit Heath Services, Haifa, Israel
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Marcadelli S, Stievano A, Rocco G. Policy proposals for a new welfare: the development of the family and community nurse in Italy as the key to promote social capital and social innovation. Prim Health Care Res Dev 2019; 20:e109. [PMID: 32799972 PMCID: PMC6609921 DOI: 10.1017/s146342361800083x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 07/09/2018] [Accepted: 10/08/2018] [Indexed: 11/11/2022] Open
Abstract
AIM To discuss the development of the family and community health nurse (FCHN) in Italy by focusing on three levels: organisational, political and theoretical. BACKGROUND The role of the FCHN in Italy is not yet embedded evenly across the Italian National Health System (INHS) and does not have formal recognition, either contractually or organisationally. Although complementary post-basic training has been available for over a decade, the FCHN's role in Italy currently exists only in pilot form. In some regions, the FCHN has operated for longer, thanks to which a clearer understanding of the functions and responsibilities required by the FCHN has emerged. Proposals for professional and social policies have emerged, as the FCHN's role may be an answer to health problems and a contributor to the construction of social capital, capable of influencing both individual and collective well-being. METHODS A mixed method investigation via a parallel concurrent design to identify the organisational models for the FCHN was conducted across Italy. In this paper, two profiles are discussed - family and community health nursing and FCHN - but each with its different connotations. The former refers to the practice of nursing and the latter to the nursing practitioners working with family and the community. CONCLUSION We describe the expected future outcomes for FCHNs as elements of social innovation for the development of a new welfare system.
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Affiliation(s)
- Silvia Marcadelli
- Dept of Biomedicine and Prevention - Doctoral Degree in Nursing SciencesTor Vergata University, Rome, Italy
| | - Alessandro Stievano
- Dept of Biomedicine and Prevention - Doctoral Degree in Nursing SciencesTor Vergata University, Rome, Italy
- Research coordinator Centre of Excellence for Nursing Scholarship, OPI, Rome, Italy
| | - Gennaro Rocco
- Dept of Biomedicine and Prevention - Doctoral Degree in Nursing SciencesTor Vergata University, Rome, Italy
- Director Centre of Excellence for Nursing Scholarsip, OPI, Rome, Italy
- Schools of Health Professional, Catholic University Our Lady of Good Counsel, Tirana, Albania
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Chudner I, Goldfracht M, Goldblatt H, Drach-Zahavy A, Karkabi K. Video or In-Clinic Consultation? Selection of Attributes as Preparation for a Discrete Choice Experiment Among Key Stakeholders. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2019; 12:69-82. [PMID: 29948961 DOI: 10.1007/s40271-018-0318-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Video consultations (VCs) provide increased accessibility of primary care to remote areas and overall improved care for chronic patients. They also contribute to higher patient satisfaction and improved resource management. Despite these benefits, VC integration into the health system is complex and slow. Understanding the VC-related preferences of three key stakeholders-patients, primary care physicians (PCPs) and policy makers (PMs)-is crucial for achieving optimal implementation. OBJECTIVE The aim of this study was to select relevant attributes and levels for a discrete choice experiment (DCE) of stakeholders' choice-VC or traditional in-clinic consultation (I-CC) in primary care. METHODS Ten semi-structured focus group interviews and 24 semi-structured individual interviews were conducted. Data analysis was performed inductively, using a thematic content analysis method. An attribute-ranking exercise was then conducted based on the results gleaned from the interviews. RESULTS The most important attributes when choosing either VC or I-CC, for both patients and PMs, were: (1) time to next available appointment; (2) time in line before consultation; (3) relationship to PCP; and (4) quality of consultation. For PCPs, the most important attributes were: (1) time in line before consultation; (2) patient's self-management ability; (3) consultation purpose; (4) quality of consultation. CONCLUSIONS This qualitative study identified attributes and levels for a DCE quantitative stage among three key stakeholder groups. It adds to the literature of examples of developing DCE attributes, and to literature about the stakeholder benefits in the area of telemedicine in healthcare.
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Affiliation(s)
- Irit Chudner
- Family Medicine Department, The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
| | - Margalit Goldfracht
- Family Medicine Department, The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Hadass Goldblatt
- Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Anat Drach-Zahavy
- Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Khaled Karkabi
- Family Medicine Department, The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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Distance to the Pediatric Emergency Department and Nonurgent Visits in Friuli Venezia Giulia, Italy. Pediatr Emerg Care 2018; 34:193-197. [PMID: 27749627 DOI: 10.1097/pec.0000000000000852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Our objective was to assess how the distance from home to the closest pediatric emergency department (ED) affects nonurgent emergency room visits among the child population of the Northeastern Italian region of Friuli Venezia Giulia. METHODS The study was based on the administrative databases of the Regional Health Information System of Friuli Venezia Giulia. For the year 2014, we abstracted the records of all white-triage-tag visits of children younger than 16 years from the databases of the 3 regional pediatric EDs located in the 3 main cities. Those records were individually linked to the regional population's georeferenced address database through an anonymous univocal identifier. For each child younger than 16 years living within 20 km from an ED, we calculated the linear distance between the ED and home address. Distances were grouped into 7 circular distance bands: less than 2, 2 to 4, 4 to 6, 6 to 8, 8 to 10, 10 to 15, and 15 to 20 km. Within each band, we calculated the rate of ED visits during the year. RESULTS In 2014, there were 12,055 white-triage-tag visits accounting for 24.7% of all visits in the regional pediatric EDs. Although the overall rate of ED visits was different among the EDs, it decreased significantly with increasing distance to the ED, with a 6-fold difference between the innermost and the outermost bands. CONCLUSIONS In Friuli Venezia Giulia, short distance is a prompter for inappropriate pediatric ED attendance. Further research is needed in this region to understand the parental standpoint to implement strategies promoting uniform behaviors within the regional boundaries.
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Salloum RG, Shenkman EA, Louviere JJ, Chambers DA. Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: a systematic review. Implement Sci 2017; 12:140. [PMID: 29169397 PMCID: PMC5701380 DOI: 10.1186/s13012-017-0675-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 11/15/2017] [Indexed: 01/11/2023] Open
Abstract
Background One of the key strategies to successful implementation of effective health-related interventions is targeting improvements in stakeholder engagement. The discrete choice experiment (DCE) is a stated preference technique for eliciting individual preferences over hypothetical alternative scenarios that is increasingly being used in health-related applications. DCEs are a dynamic approach to systematically measure health preferences which can be applied in enhancing stakeholder engagement. However, a knowledge gap exists in characterizing the extent to which DCEs are used in implementation science. Methods We conducted a systematic literature search (up to December 2016) of the English literature to identify and describe the use of DCEs in engaging stakeholders as an implementation strategy. We searched the following electronic databases: MEDLINE, Econlit, PsychINFO, and the CINAHL using mesh terms. Studies were categorized according to application type, stakeholder(s), healthcare setting, and implementation outcome. Results Seventy-five publications were selected for analysis in this systematic review. Studies were categorized by application type: (1) characterizing demand for therapies and treatment technologies (n = 32), (2) comparing implementation strategies (n = 22), (3) incentivizing workforce participation (n = 11), and (4) prioritizing interventions (n = 10). Stakeholders included providers (n = 27), patients (n = 25), caregivers (n = 5), and administrators (n = 2). The remaining studies (n = 16) engaged multiple stakeholders (i.e., combination of patients, caregivers, providers, and/or administrators). The following implementation outcomes were discussed: acceptability (n = 75), appropriateness (n = 34), adoption (n = 19), feasibility (n = 16), and fidelity (n = 3). Conclusions The number of DCE studies engaging stakeholders as an implementation strategy has been increasing over the past decade. As DCEs are more widely used as a healthcare assessment tool, there is a wide range of applications for them in stakeholder engagement. The DCE approach could serve as a tool for engaging stakeholders in implementation science. Electronic supplementary material The online version of this article (10.1186/s13012-017-0675-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ramzi G Salloum
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
| | - Elizabeth A Shenkman
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Jordan J Louviere
- Institute for Choice, School of Marketing, University of South Australia, Adelaide, SA, Australia
| | - David A Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Kleij KS, Tangermann U, Amelung VE, Krauth C. Patients' preferences for primary health care - a systematic literature review of discrete choice experiments. BMC Health Serv Res 2017; 17:476. [PMID: 28697796 PMCID: PMC5505038 DOI: 10.1186/s12913-017-2433-7] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 07/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary care is a key element of health care systems and addresses the main health problems of the population. Due to the demographic change, primary care even gains in importance. The knowledge of the patients' preferences can help policy makers as well as physicians to set priorities in their effort to make health care delivery more responsive to patients' needs. Our objective was to describe which aspects of primary care were included in preference studies and which of them were the most preferred aspects. METHODS In order to elicit the preferences for primary care, a systematic literature search was conducted. Two researchers searched three electronic databases (PubMed, Scopus, and PsycINFO) and conducted a narrative synthesis. Inclusion criteria were: focus on primary health care delivery, discrete choice experiment as elicitation method, and studies published between 2006 and 2015 in English language. RESULTS We identified 18 studies that elicited either the patients' or the population's preferences for primary care based on a discrete choice experiment. Altogether the studies used 16 structure attributes, ten process attributes and four outcome attributes. The most commonly applied structure attribute was "Waiting time till appointment", the most frequently used process attribute was "Shared decision making / professional's attention paid to your views". "Receiving the 'best' treatment" was the most commonly applied outcome attribute. Process attributes were most often the ones of highest importance for patients or the population. The attributes and attribute levels used in the discrete choice experiments were identified by literature research, qualitative research, expert interviews, or the analysis of policy documents. CONCLUSIONS The results of the DCE studies show different preferences for primary health care. The diversity of the results may have several reasons, such as the method of analysis, the selection procedure of the attributes and their levels or the specific research question of the study. As the results of discrete choice experiments depend on many different factors, it is important for a better comprehensibility of the studies to transparently report the steps undertaken in a study as well as the interim results regarding the identification of attributes and levels.
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Affiliation(s)
- Kim-Sarah Kleij
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hanover, Germany
| | - Ulla Tangermann
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hanover, Germany
| | - Volker E. Amelung
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hanover, Germany
| | - Christian Krauth
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hanover, Germany
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Berhane A, Enquselassie F. Patients' preferences for attributes related to health care services at hospitals in Amhara Region, northern Ethiopia: a discrete choice experiment. Patient Prefer Adherence 2015; 9:1293-301. [PMID: 26396501 PMCID: PMC4574886 DOI: 10.2147/ppa.s87928] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Information from the patient's point of view is essential in policy and clinical decisions. Prioritizing what patients value, need, and prefer in various aspects of a health program can be helpful in evaluating and designing hospital health care services. OBJECTIVE To examine patients' preference for attributes related to health care services and to ascertain the relative impact of attributes at hospitals in Amhara Region, northern Ethiopia. METHODS A stated-preference discrete choice experiment survey was performed in multistage, stratified, and systematic sampling of patients who visited the hospitals. Attributes were selected based on a literature review of the most important characteristics of hospital health care service and reviewed and validated with inputs from patients and researchers in the field. Attributes included in the study were waiting time, physician communication, nursing communication, drug availability, continuity of care, and diagnostic facilities. A random-effects probit model was used to perform the analysis. RESULTS One thousand and five respondents who received care in the outpatient and inpatient departments participated in the study. All attributes included in the study affected the choice of hospital. Patients were willing to wait up to 3.3 hours and 2.7 hours to get full drugs in the hospital and good nursing communication, respectively. The interaction terms indicate that preferences differ with the variables sex, occupation, and type of hospital. Patients expressed clear preferences in a decreasing order of all the significant attribute levels: a lot of diagnostic facilities, full drug availability, continuity of care, good nursing communication, partial drug availability, good physician communication, and shorter waiting time for the consultation. CONCLUSION Different hospital care attributes had a significant and different influence on patients' choice of hospital. The study informs about patients' preferences and the trade-offs among different possible process-related attributes. Decision makers should focus on patient preferences and consider selected attributes when designating hospital services, and hence to maximize patient satisfaction.
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Affiliation(s)
- Adugnaw Berhane
- College of Health Sciences, Debre Berhan University, Addis Ababa, Ethiopia
- Correspondence: Adugnaw Berhane, College of Health Sciences, Debre Berhan University, PO Box 100796, Addis Ababa, Ethiopia, Tel +251 91 139 1111, Email
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