scholarly journals Preferences for healthcare services among hypertension patients in China: a discrete choice experiment

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053270
Author(s):  
Xiaolan Yu ◽  
Haini Bao ◽  
Jianwei Shi ◽  
Xiaoyu Yuan ◽  
Liangliang Qian ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Healthcare Providers ◽  
Mixed Logit ◽  
Good Health ◽  
Healthcare Services ◽  
Efficient Design ◽  
Healthcare Facilities ◽  
Patient Centred Care

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.

scholarly journals Experts’ preferences for sarcopenia outcomes: a discrete-choice experiment from a working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) in collaboration with the European Union of Geriatric Medicine Society (EUGMS)

2021 ◽  
Author(s):  
Charlotte Beaudart ◽  
◽  
Jürgen M. Bauer ◽  
Francesco Landi ◽  
Olivier Bruyère ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Musculoskeletal Diseases ◽  
Geriatric Medicine ◽  
Mixed Logit ◽  
The European Union ◽  
Domestic Activities

Abstract Background and aims To assess experts’ preference for sarcopenia outcomes. Methods A discrete-choice experiment was conducted among 37 experts (medical doctors and researchers) from different countries around the world. In the survey, they were repetitively asked to choose which one of two hypothetical patients suffering from sarcopenia deserves the most a treatment. The two hypothetical patients differed in five pre-selected sarcopenia outcomes: quality of life, mobility, domestic activities, fatigue and falls. A mixed logit panel model was used to estimate the relative importance of each attribute. Results All sarcopenia outcomes were shown to be significant, and thus, important for experts. Overall, the most important sarcopenia outcome was falls (27%) followed by domestic activities and mobility (24%), quality of life (15%) and fatigue (10%). Discussion and conclusion Compared to patient’s preferences, experts considered falls as a more important outcome of sarcopenia, while the outcomes fatigue and difficulties in domestic activities were considered as less important.

scholarly journals Understanding uptake of digital health products: Methodology tutorial for a Discrete Choice Experiment using a Bayesian efficient design (Preprint)

2021 ◽  
Author(s):  
Dorothy Szinay ◽  
Rory Cameron ◽  
Felix Naughton ◽  
Jennifer A. Whitty ◽  
Jamie Brown ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Stated Preference ◽  
Digital Health ◽  
Revealed Preferences ◽  
Quantitative Methodology ◽  
Efficient Design ◽  
Trade Offs ◽  
Health Products

UNSTRUCTURED Understanding the preferences of potential users of digital health products is beneficial for digital health policy and planning. Stated preference methods could help elicit individuals’ preferences in the absence of observational data. A discrete choice experiment (DCE) is a commonly used stated preference method; a quantitative methodology that argues that individuals make trade-offs when engaging in a decision by choosing an alternative of a product or service that offers the greatest utility, or benefit. This methodology is widely used in health economics in situations where revealed preferences are difficult to collect but is much less used in the field of digital health. This article outlines the stages involved in developing a discrete choice experiment. As a case study, it uses the application of a DCE for revealing preferences in targeting the uptake of smoking cessation apps. It describes the establishment of attributes, the construction of choice tasks of two or more alternatives, and the development of the experimental design. This tutorial offers a guide for researchers with no prior knowledge of this research technique.

scholarly journals Finding the best fit: examining the decision-making of augmentative and alternative communication professionals in the UK using a discrete choice experiment

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030274
Author(s):  
Edward J D Webb ◽  
Yvonne Lynch ◽  
David Meads ◽  
Simon Judge ◽  
Nicola Randall ◽  
...  
Keyword(s):  
Decision Making ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Augmentative And Alternative Communication ◽  
Mixed Logit ◽  
Information Criterion ◽  
Alternative Communication ◽  
Trade Offs ◽  
The Uk

ObjectivesMany children with varied disabilities, for example, cerebral palsy, autism, can benefit from augmentative and alternative communication (AAC) systems. However, little is known about professionals’ decision-making when recommending symbol based AAC systems for children. This study examines AAC professionals’ preferences for attributes of AAC systems and how they interact with child characteristics.DesignAAC professionals answered a discrete choice experiment survey with AAC system and child-related attributes, where participants chose an AAC system for a child vignette.SettingThe survey was administered online in the UK.Participants155 UK-based AAC professionals were recruited between 20 October 2017 and 4 March 2018.OutcomesThe study outcomes were the preferences of AAC professionals’ as quantified using a mixed logit model, with model selection performed using a step-wise procedure and the Bayesian Information Criterion.ResultsSignificant differences were observed in preferences for AAC system attributes, and large interactions were seen between child attributes included in the child vignettes, for example, participants made more ambitious choices for children who were motivated to communicate using AAC, and predicted to progress in skills and abilities. These characteristics were perceived as relatively more important than language ability and previous AAC experience.ConclusionsAAC professionals make trade-offs between attributes of AAC systems, and these trade-offs change depending on the characteristics of the child for whom the system is being provided.

scholarly journals Understanding HIV-positive patients' preferences for healthcare services: a protocol for a discrete choice experiment

BMJ Open ◽  
2016 ◽  
Vol 6 (7) ◽  
pp. e008549 ◽  
Author(s):  
Elaney Youssef ◽  
Vanessa Cooper ◽  
Alec Miners ◽  
Carrie Llewellyn ◽  
Alex Pollard ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Healthcare Services ◽  
Hiv Positive

scholarly journals Location, Location, Location: A Discrete Choice Experiment to Inform Vaccination Programme Delivery in the UK

2021 ◽  
Author(s):  
Robert McPhedran ◽  
Natalie Gold ◽  
Charlotte Bemand ◽  
Dale Weston ◽  
Rachel Rosen ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Vaccination Programme ◽  
Logit Model ◽  
Choice Experiment ◽  
Large Scale ◽  
Mixed Logit ◽  
Fractional Factorial ◽  
Delivery Mode ◽  
The Uk

Abstract BackgroundLarge-scale vaccination is fundamental to combatting COVID-19. In March 2021, the UK’s vaccination programme had delivered vaccines to large proportions of older and more vulnerable population groups; however, there was concern that uptake would be lower among young people. This research was designed to elicit the preferences of 18-29-year-olds with respect to key delivery characteristics.MethodsFrom 25 March - 2 April 2021, an online sample of 2,021 UK adults aged 18-29 years participated in a Discrete Choice Experiment. Participants made six choices, each between two SMS invitations to get vaccinated; each choice also had an opt-out. Each invitation had four attributes (1 x 5 levels, 3 x 3 levels): delivery mode, appointment timing, proximity, and SMS sender. These were systematically varied according to a d-optimal fractional factorial design. Order of presentation was randomised for each participant. Responses were analysed using a mixed logit model.ResultsThe logit model revealed a large alternative-specific constant (β = 1.385, SE = 0.067, p <0.001), indicating a strong preference for ‘opting in’ to appointment invitations. Pharmacies were dispreferred to the local vaccination centre (β = -0.256, SE = 0.072, p <0.001), appointments in locations that were 30-45 minutes travel time from one’s premises were dispreferred to locations that were less than 15 minutes away (β = -0.408, SE = 0.054, p <0.001), and, compared to invitations sent by the NHS, SMSs forwarded by ‘a friend’ were dispreferred (β = -0.615, SE = 0.056, p <0.001) but invitations from the General Practitioner were preferred (β = 0.105, SE = 0.048, p = 0.028).ConclusionsThe results indicated that the existing configuration of the UK’s mass vaccination programme was well-placed to deliver vaccines to 18-29-year-olds; however, some adjustments might enhance acceptance. Local pharmacies were not preferred; long travel times were a disincentive but close proximity (0-15 minutes from one’s premises) was not necessary; and either the ‘NHS’ or ‘Your GP’ would serve as adequate invitation sources. This research informed COVID-19 policy in the UK, and contributes to a wider body of Discrete Choice Experiment evidence on citizens’ preferences, requirements and predicted behaviours regarding COVID-19.

scholarly journals Valuing EQ-5D-Y-3L Health States Using a Discrete Choice Experiment: Do Adult and Adolescent Preferences Differ?

2021 ◽  
pp. 0272989X2199960
Author(s):  
David J. Mott ◽  
Koonal K. Shah ◽  
Juan Manuel Ramos-Goñi ◽  
Nancy J. Devlin ◽  
Oliver Rivero-Arias
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Mixed Logit ◽  
Self Care ◽  
Attribute Importance ◽  
Health States ◽  
Two Samples ◽  
Value Sets ◽  
Anxiety Depression

Background An important question in the valuation of children’s health is whether the preferences of younger individuals should be captured within value sets for measures that are aimed at them. This depends on whether younger individuals can complete valuation exercises and whether their preferences differ from those of adults. This study compared the preferences of adults and adolescents for EQ-5D-Y-3L health states using latent scale values elicited from a discrete choice experiment (DCE). Methods An online DCE survey, comprising 15 pairwise choices, was provided to samples of UK adults and adolescents (aged 11–17 y). Adults considered the health of a 10-year-old child, whereas adolescents considered their own health. Mixed logit models were estimated, and comparisons were made using relative attribute importance (RAI) scores and a pooled model. Results In total, 1000 adults and 1005 adolescents completed the survey. For both samples, level 3 in pain/discomfort was most important, and level 2 in self-care the least important, based on the relative magnitudes of coefficients. The RAI scores (normalized on self-care) indicated that adolescents gave less weight relative to adults to usual activities (1.18 v. 1.51; P < 0.05), pain/discomfort (1.77 v. 3.12; P < 0.01), and anxiety/depression (1.64 vs. 2.65; P < 0.01). The pooled model indicated evidence of differences between the two samples in both levels in pain/discomfort and anxiety/depression. Limitations The perspective of the DCE task differed between the 2 samples, and no data were collected to anchor the DCE data to generate value sets. Conclusions Adolescents could complete the DCE, and their preferences differed from those of adults taking a child perspective. It is important to consider whether their preferences should be incorporated into value sets.

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

2019 ◽  
Vol 8 (8) ◽  
pp. 488-497 ◽  
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.

Sign in / Sign up

Export Citation Format

Share Document