Establishing patient preferences for gastroenterology clinic reorganization using conjoint analysis

Martin, Paul; Wardman, Mark; Toner, Jeremy; Ryan, Mandy; Duffett, Sara

doi:10.1097/00042737-200204000-00017

Cited by 26 publications

(23 citation statements)

References 10 publications

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“…However, one survey of a gastroenterology clinic showed that patients placed a similar value on waiting time for investigation and waiting for the first appointment: 4 a clinic that had a two-month wait for appointment, but offered immediate investigation was preferable to one with a two-week wait for appointment but a three-month wait for investigation. The authors suggest that to focus just on 'wait to first appointment' is too simplistic and does not take account of patient preferences.…”

Section: Waiting Time and Appointmentsmentioning

confidence: 99%

Medical outpatients: changes that can benefit patients

Dunnill

Pounder

2004

Clinical Medicine

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-This article reviews the current literature relating to medical outpatient services. It has been produced as part of the RCP/NHS Confederation working party on outpatients departments. The article deals with surveys of patient views on outpatients, suggested ways of improving the service, and how best to accommodate teaching in this setting. An RCP booklet, 'How user friendly is your outpatient department?', has also been produced and is available from the college. KEY WORDS: ambulatory care, appointment, booking, clinic, outpatient, waiting timeMost physicians spend a significant part of their week working in the outpatient department but although the consultation in the outpatient clinic is an important part of patients' hospital care, it is traditionally an under-resourced area of the hospital. There has been little research into improving the service and, as a result, the experience for patients is not always as good as it should be.A well-run clinic will not only improve the experiences of patients but also the working lives of clinic staff. It may reduce the need for admission to hospital, both for disease control and for its investigation. 1 There is currently also political pressure for change, particularly regarding waiting times. The Government has recently issued a target of a maximum of three months wait for all outpatients' appointments by 2005. 2 This article reviews the literature relating to outpatients, with a focus on medical outpatients. The Working Party's aim was to develop recommendations to enable physicians to improve the experience for patients attending their clinics, and the work culminated in the publication of a booklet for health professionals. 3 Inevitably, in this paper there is some overlap with managerial issues (for example, direct booking systems or computer referral systems), and while some of these are beyond the scope of this article, they are addressed where physicians will be expected to work with managers to improve service delivery. Search strategyThe bibliographic databases Medline and Embase were searched for articles on outpatients, hospital outpatient clinics, outpatient departments or ambulatory care. Papers on day care were excluded. The results were limited to the UK, to the years 1966-2002 and to papers in English with abstracts available. Surveys of patient attitudes and satisfaction Waiting time and appointmentsLong waits for a first outpatient appointment are a common cause of patient dissatisfaction. However, one survey of a gastroenterology clinic showed that patients placed a similar value on waiting time for investigation and waiting for the first appointment: 4 a clinic that had a two-month wait for appointment, but offered immediate investigation was preferable to one with a two-week wait for appointment but a three-month wait for investigation. The authors suggest that to focus just on 'wait to first appointment' is too simplistic and does not take account of patient preferences.The length of time patients have to wait in the clinic before ...

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Section: Waiting Time and Appointmentsmentioning

confidence: 99%

Medical outpatients: changes that can benefit patients

Dunnill

Pounder

2004

Clinical Medicine

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“…In the last few years its use has become increasingly common in health economics. Studies have used stated preference modeling to predict participation rates of chickenpox vaccination by parents [4], to model migraine medication choice by patients [5], to model choice of health plans [6][7][8] value of magnetic resonance imaging for investigation of knee injuries [9], to estimate patient preferences for clinical waiting times [10], to estimate demand for hospital services [11], to estimate demand for in vitro fertilization [12], to elicit preferences for miscarriage management [13], to assess preferences in the doctor-patient relationship [14], and to measure time preferences for health and willingness to pay for longevity [15,16].…”

Section: Introductionmentioning

confidence: 99%

Using stated preference and revealed preference modeling to evaluate prescribing decisions

Mark¹,

Swait́

2003

Health Economics

130

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The use of stated preference analyses to evaluate choice of health care products has been growing in recent years. This paper shows how revealed preference data can be enriched with stated preference data and highlights the relative advantages of revealed and stated preference data. The techniques were applied to a study of determinants of physicians' prescriptions of alcoholism medications. Analyses were conducted on the relationship between physicians' perceptions of existing alcoholism medication attributes and their prescribing rates of those medications. Analyses were also conducted on physicians' decisions to prescribe hypothetical alcoholism medications with varying attributes such as efficacy, side effects, compliance, mode of action, and price. Finally, analyses were conducted on the combined stated and revealed preference data. Joint estimation suggests that parameters from the revealed and stated preference data are equal, up to scale. Joint analyses highlight how stated preference data can be used to estimate parameters for attributes that are not observed in the marketplace, that do not vary in the marketplace, or that are highly collinear with other attributes in actual markets.

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“…Adopting measures to improve these two main problems would have a high probability of reducing the problem rate encountered by our patients [14]. Generally speaking, waiting times are an important determinant for patient satisfaction in varying clinical contexts emergency, pediatric care, colonoscopy appointments, or primary care medical appointments [15][16][17][18]. Data from the research of Moayyedi et al [16] underline the importance of waiting time until the appointment when carrying out complementary gastrointestinal examinations.…”

Section: Discussionmentioning

confidence: 99%