Eliciting preferences for outpatient care experiences in Hungary: A discrete choice experiment with a national representative sample

Abstract

Introduction Patient-reported experience measures (PREMs) are central to inform on the responsiveness of health systems to citizens' health care needs and expectations. At their current form, PREMs do not reflect the weights that patients assign to varying aspects of the care experience. We aimed to investigate patients' preferences and willingness to pay (WTP) for attributes of the care experience in outpatient settings. Methods A discrete choice experiment was conducted among a representative sample of the general adult population of Hungary (n = 1000). Choice set attributes and levels were defined based on OECD's standardized PREMs (e.g. a doctor spending enough time in consultation, providing easy to understand explanations, giving opportunity to ask questions, and involving in decision making) and a price attribute. Conditional and mixed logit analyses were conducted. WTP estimates were computed in preference and WTP space. Results The respondents most preferred attribute was that of a doctor spending enough time in consultation, followed by involvement in decision making. Moreover, waiting times had a less important effect on respondents' choice preference compared with aspects of the doctorpatient relationship. Estimates in the WTP space varied from €4.38 (2.85-5.90) for waiting an hour less at a doctor's office to €36.13 (32.07-40.18) for a consultation where a doctor spends enough time with a patient relative to a consultation where a doctor does not. Conclusions A preference-based PREMs approach provide insight on the value patients assign to different aspects of their care experience. This can inform the decisions of policy-makers and

Understanding the use of patient-reported data by health care insurers: A scoping review

“…Third, contextual factors, such as country-specific legislation, data protection regulation, the organization of the healthcare system, and market competition may influence the diffusion of the use of patient-reported data across a health insurer's business. As suggested by Klose et al (2016) [80] and Brito Fernandes et al (2020) [8], the knowledge about patients' needs, preferences, and experiences could help organizations such as health insurers in developing and optimizing a patient-centered approach.…”

“…fit for risk-adjustment or a people-centered approach to developing such measures) offer another layer of complexity to the conceptualizations of such data. This context also sets the opportunity for new measures to arise, such as that of patient-reported outcome-based performance measures [51,56] and preference-based PREMs [8].…”

“…To strengthen people-centeredness and strive towards QoC and VBHC, health system stakeholders (e.g. health care insurers and care providers) should commit to the value agenda supported by intelligence on the healthcare system users' needs, expectations, and preferences [7][8][9]. Hence, patient-reported data have become crucial to gain insight on one's voice and inform the decisions of those key stakeholders.…”

“…Health insurers are no longer solely focused on cost containment and cost-effectiveness, but also on adequate health service design and planning of improved health of the (insured) population [22]. Hence, research on the use of patient-reported data by health insurers can help to determine to what extent health insurers respond to the insurees' needs and preferences [8,20].…”

Self-Reported Waiting Times for Outpatient Health Care Services in Hungary: Results of a Cross-Sectional Survey on a National Representative Sample

“…Furthermore, considering the cultural context, the weight citizens assign to waiting time attributes is relatively small compared to that of other features of health care services (e.g., a doctor providing easy to understand explanations, or involving the patient in decision-making about care/treatment). Recent evidence from a discrete choice experiment in which the full sample of the survey ‘Patient experiences in health care’ was used, showed that respondents’ willingness to pay varied from €4.38 to wait an hour less at a doctor’s office to €5.46 for one week reduction in the waiting time for an appointment; by comparison, other attributes of the care experience were highly valued (e.g., on average, respondents were willing to pay €36.13 more to have an appointment with a doctor that spends enough time in consultation with a patient) [ 28 ].…”