Preferences of Bulgarian consumers for quality, access and price attributes of healthcare services-result of a discrete choice experiment

ObjectivesOur study aimed to support evidence-informed policy-making on patient-centred care by investigating preferences for healthcare services among hypertension patients.DesignWe 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.SettingThe DCE was conducted in Jiangsu province and Shanghai municipality in China.ParticipantsPatients aged 18 years or older with a history of hypertension for at least 2 years and who took medications regularly were recruited.ResultsPatients 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.ConclusionsOur 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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What influences where they seek care? Caregivers’ preferences for under-five child healthcare services in urban slums of Malawi: A discrete choice experiment

PLoS ONE ◽

10.1371/journal.pone.0189940 ◽

2018 ◽

Vol 13 (1) ◽

pp. e0189940 ◽

Cited By ~ 3

Author(s):

Edgar Arnold Lungu ◽

Amarech Guda Obse ◽

Catherine Darker ◽

Regien Biesma

Keyword(s):

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Healthcare Services ◽

Urban Slums ◽

Under Five ◽

Child Healthcare

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Eliciting Preferences for Health Insurance in Iran Using Discrete Choice Experiment Analysis

International Journal of Health Policy and Management ◽

10.15171/ijhpm.2019.29 ◽

2019 ◽

Vol 8 (8) ◽

pp. 488-497 ◽

Cited By ~ 1

Author(s):

Ali Kazemi Karyani ◽

Ali Akbari Sari ◽

Abraha Woldemichael

Keyword(s):

Health Insurance ◽

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Conditional Logistic Regression ◽

Total Sample ◽

Healthcare Services ◽

Public Hospitals ◽

Logistic Regression Models ◽

Clinical Benefits

Background: The preferences of Iranians concerning the attributes of health insurance benefit packages are not well studied. This study aimed to elicit health insurance preferences among insured people in Iran during 2016. Methods: A mixed methods study using a discrete choice experiment (DCE) approach was conducted to elicit health insurance preferences on a total sample of 600 insured Iranians residing in Tehran. The final design of the DCE included 8 health insurance attributes. Data were analyzed using conditional logistic regression models. Results: The final model of this DCE study included 8 attributes, and the findings indicated statistically significant (P<.001) increase in the odds ratio (OR) of choosing health insurance at all levels of cost coverage except for the rehabilitation and para-clinical benefits, where at 70% cost coverage there was insignificant (P=.485) disutility (OR=0.95). With the increase in cost coverage level, the probability of choosing health insurance was significantly (P<.001) the highest for the private hospitals’ benefits (OR=2.82) followed by public hospitals’ benefits (OR=2.02) and outpatient benefits (OR=1.75), and the premium revealed statistically significant (P<.001) disutility (OR=0.96). Conclusion: Our findings revealed that participants would be willing to choose health insurance plans with higher cost coverage of healthcare services and with lower premiums. However, the demographic characteristics, income, and health status of the insured individuals affected their health insurance preferences. The findings can contribute to the design of better health insurance policies, improve the participation of individuals in health insurance, and increase the insured individuals’ utility from the insurance benefits packages.

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Doctor’s Preference in Providing Medical Service for Patients in the Medical Alliance: A Pilot Discrete Choice Experiment

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072215 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2215

Author(s):

Richard Huan Xu ◽

Lingming Zhou ◽

Yong Li ◽

Dong Wang

Keyword(s):

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Healthcare Services ◽

Working Time ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Trade Offs ◽

Utility Scores

This cross-sectional survey study explored whether doctors in Guangdong, China preferred to provide extra healthcare services within the context of their medical alliances (MAs). Specifically, a discrete choice experiment (DCE) was conducted to investigate whether doctors preferred to provide extra services at low-tier hospitals within their MAs. A literature review, focus group interview, and expert group discussion resulted in three main attributes (i.e., working time, income, and hospital location) and corresponding levels, which were combined to create 24 profiles that were randomly presented to participants. A conditional logit model was then employed to calculate utility scores for all profiles. A total of 311 doctors completed the DCE questionnaire. The coefficients for each level within the three attributes were ordered and found to be statistically significant. Working time had the greatest influence on utility scores, increasing by one hour per week (beta = 1.4, odds ratio (OR) = 4.07, p < 0.001), followed by income, which increased by 30% per month (beta = 1.19, OR = 3.3, p < 0.001). The utility scores for all profiles ranged between −0.27 and 3.07. Findings indicated that participants made trade-offs with respect to providing extra services within their MAs. Furthermore, utility varied between different subpopulations.

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