Determining patient preferences in a glaucoma service: A discrete choice experiment

作者：Thomas Chengxuan Lu, Blake Angell, Hamish Dunn, Belinda Ford, Andrew White, Lisa Keay · 发表于：Clinical and Experimental Ophthalmology · 年份：2019 · DOI：10.1111/ceo.13606 · 被引用次数：14 · 研究领域：Economic and Environmental Valuation、Patient-Provider Communication in Healthcare、Healthcare Operations and Scheduling Optimization

IMPORTANCE: Patient perspectives are crucial in informing design of acceptable services. BACKGROUND: This study determined patient preferences in glaucoma care. DESIGN: A discrete choice experiment was used to evaluate the relative importance of out-of-pocket costs, waiting time, continuity of care, service location and expertise. PARTICIPANTS: Ninety-eight glaucoma suspects or glaucoma patients were recruited from one public and two private clinics in Sydney. METHODS: Twelve choice-tasks were presented in random order and forced-choice preferences were elicited. Choice data were analysed using a multinominal logit model (NLOGIT 4.0). MAIN OUTCOME MEASURES: The relative importance and the likelihood of choosing services with each attribute were determined. Willingness-to-pay and willingness-to-wait were calculated. Analyses were stratified by whether the patient attended a public or private glaucoma clinic and other demographic features. RESULTS: Choice was influenced by four or five attributes: greater clinician expertise, the same clinician each visit, lower out-of-pocket costs and shorter wait times (all P < .05). Respondents were willing to pay an additional (Australian dollars) $325 (95% confidence interval [CI] 188-389) to see a senior eye doctor, and $87 (95% CI 60-116) to see the same clinician each visit. Respondents were willing to wait for these attributes; however, the estimates had wide confidence intervals and were beyond the range tested. Private patients had a...