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患者对私人助听器经销商直接提供助听器的偏好:一项离散选择实验。

Patient preferences for direct hearing aid provision by a private dispenser. A discrete choice experiment.

作者信息

Grutters Janneke P C, Joore Manuela A, Kessels Alfons G H, Davis Adrian C, Anteunis Lucien J C

机构信息

Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, the Netherlands.

出版信息

Ear Hear. 2008 Aug;29(4):557-64. doi: 10.1097/AUD.0b013e3181734a19.

Abstract

OBJECTIVES

Our objective was to elicit patient preferences for transferring elements of hearing aid provision from the medical sector [Ear Nose and Throat (ENT) specialists and audiological centers] to private hearing aid dispensers, and to understand the trade-offs between different elements of hearing aid provision.

DESIGN

A discrete choice experiment was administered from 150 hearing-impaired persons in the Netherlands. Mean age was 71 (range 18-95) and 57% were male.

RESULTS

Participants preferred the initial assessment at the dispenser, higher accuracy in identifying persons in need of medical care, shorter duration of the total hearing aid provision, and a follow-up at the ENT specialist. They required compensation of at least euro 17 per 2 mo extra duration, euro 54 for an initial assessment at the ENT specialist, euro 119 per 10% decrease in accuracy, and euro 227 to forgo the follow-up at the ENT specialist. Preferences were influenced by sex, age, educational level, and experience with hearing aid provision.

CONCLUSIONS

Hearing-impaired persons are receptive to transferring elements of hearing aid provision from the medical sector to private dispensers. Although safety and efficiency issues should also be considered, from the present study we can conclude that in the organization of hearing aid provision hearing-impaired persons prefer an initial assessment at a private dispenser when the dispenser is at least 95% as accurate as the ENT specialist, and prefer a follow-up visit at the ENT specialist.

摘要

目的

我们的目标是了解患者对于将助听器配置环节从医疗部门(耳鼻喉科专家和听力中心)转移至私人助听器经销商的偏好,并理解助听器配置不同环节之间的权衡取舍。

设计

对荷兰150名听力受损者进行了一项离散选择实验。平均年龄为71岁(范围18 - 95岁),男性占57%。

结果

参与者更倾向于在经销商处进行初始评估、在识别需要医疗护理的人员方面有更高的准确性、助听器配置总时长更短,以及由耳鼻喉科专家进行随访。他们要求每延长2个月额外时长至少补偿17欧元,在耳鼻喉科专家处进行初始评估补偿54欧元,准确性每降低10%补偿119欧元,放弃耳鼻喉科专家的随访补偿227欧元。偏好受到性别、年龄、教育水平以及助听器配置经验的影响。

结论

听力受损者愿意接受将助听器配置环节从医疗部门转移至私人经销商。尽管也应考虑安全和效率问题,但从本研究我们可以得出结论,在助听器配置的组织安排中,当经销商的准确性至少达到耳鼻喉科专家的95%时,听力受损者更倾向于在私人经销商处进行初始评估,并倾向于由耳鼻喉科专家进行随访。

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