Preferences of Patients with Non-Communicable Diseases for Primary Healthcare Facilities: A Discrete Choice Experiment in Wuhan, China

Abstract

Objectives: To elicit stated preferences of patients with non-communicable diseases (NCDs) for primary healthcare (PHC) facilities and to explore the willingness-to-pay (WTP) for facility attributes. Methods: A discrete choice experiment (DCE) was conducted through face to face interviews. The DCE survey was constructed by five attributes: type of service, treatment measures, cost, travel time, and care provider. Patients’ preferences and willingness to pay for facility attributes were analyzed using a mixed logit model, and interaction terms were used to assess preference heterogeneity among patients with different sociodemographic characteristics. Results: Patients placed different weights on attributes, depending on whether they perceived their health condition as minor or severe. For conditions perceived as minor, patients valued treatment measures (56.60%), travel time (32.34%) and care provider (8.51%) most. For conditions perceived as severe, they valued treatment measures (52.19%), care provider (38.69%), and type of service (7.30%) most. The WTP related to the change from Traditional Chinese Medicine (TCM) service to Modern Medicine (MM) service was the largest for both severity scenarios. For conditions perceived as minor, patients would be willing to pay 102.84 CNY (15.43 USD) for a reduction in travel time to below 30 min. For conditions perceived as severe, WTP related to the change from general service to specialized service and from junior medical practitioner to senior medical practitioner, were highly valued by respondents, worth 107.3 CNY (16.10 USD) and 565.8 CNY (84.87 USD), respectively. Conclusions: Factors related to the provision of PHC, such as treatment measures, care provider and type of service were highly valued. The findings could contribute to the design of better PHC delivery, improve the participation of patients in PHC, and provide some evidence to promote shared decision-making.

Identification and Prioritization of Attributes for a Discrete Choice Experiment Using the Nominal Group Technique: Patients’ Choice of Public Health Facilities in Cape Town, South Africa

“…15 These factors were also found in studies that reviewed the access, availability, and affordability of healthcare in South Africa [15][16][17][18][19] and in other countries including Albania, China, Iran, Jordan, Nigeria, Pakistan, Spain, Tanzania, and Uganda. [20][21][22][23][24][25][26][27][28][29][30][31][32][33] A list of possible attributes to be presented to the participants was compiled, with the concurrence of the Northern Tygerberg substructure team, resulting in the finalization of the pregroup discussion list. Table 1 summarizes articles from which the attributes were retrieved, mainly from South African-related articles, thus providing a glimpse into patient preferences in the country of study.…”

“…Some studies did not quite mirror the attributes extracted from our group discussions, possibly caused by different objectives and study methodologies. Studies in South Africa, 9 China, 21,25,26,29,30 India, 20 Iran, 27 Jordan, 33 Spain, 28 and Albania 44 included age, education, employment, travel time, transport costs, chronic illness, medication availability, illness gravity, accessibility, type of service provided, previous experience, care providers, and facilities infrastructure.…”

Enhancing Public Participation in Public Health Offerings: Patient Preferences for Facilities in the Western Cape Province Using a Discrete Choice Experiment

“…The findings were consistent with Honda et al [ 5 ], of which drug availability was identified as the most important issue. The literature demonstrates treatment measures to be the most important factors that affect healthcare seeking [ 28 ]. This study reveals that patients have preferences for certain characteristics of health facilities: near (short distances to health facility), with absolute confidentiality during visits, with short first visit waiting and appointment waiting time, where treatment is offered by doctors, and where all required medication is available.…”

“…Even though there is a large body of work on stated preferences, only a few studies have been conducted regarding patients’ choice of facility, specifically within public health care. A systematic review of DCEs used to elicit patient preferences for primary healthcare showed that most studies were American or European, and focused on general practitioner (GP) consultations, [ 26 ] while Chinese studies appeared to focus primarily on the public health preferences of rural populations [ 27 , 28 , 29 , 30 ]. Only one South African DCE of public health facility preferences was identified [ 5 ].…”

Physical Activity in the Daily Life of Adolescents: Factors Affecting Healthy Choices from a Discrete Choice Experiment

“…They are ultimately intended to extrapolate respondents’ preferences starting from their stated preferences in hypothetical scenarios [ 89 ]. The authors selected such a kind of experiment with the aim to identify adolescents’ preferences for PA so as to allow the design of effectively tailored health promotion policies, because discrete choice models are considered as one of the most adequate techniques for preferences elicitation [ 90 , 91 ].…”