Ratcliffe Julie, Lancsar Emily, Luszcz Mary, Crotty Maria, Gray Len, Paterson Jan, Cameron Ian D
Flinders Health Economics Group, School of Medicine, Flinders University, Adelaide, South Australia, Australia.
Centre for Health Economics, Monash University, Clayton, Victoria, Australia.
BMJ Open. 2014 Jun 25;4(6):e005788. doi: 10.1136/bmjopen-2014-005788.
Consumer-directed care is currently being embraced within Australia and internationally as a means of promoting autonomy and choice in the delivery of health and aged care services. Despite its wide proliferation little research has been conducted to date to assess the views and preferences of older people for consumer-directed care or to assess the costs and benefits of such an approach relative to existing models of service delivery.
A comprehensive health economic model will be developed and applied to the evolution, implementation and evaluation of consumer-directed care in an Australian community aged care setting. A mixed methods approach comprising qualitative interviews and a discrete choice experiment will determine the attitudes and preferences of older people and their informal carers for consumer-directed care. The results of the qualitative interviews and the discrete choice experiment will inform the introduction of a new consumer-directed care innovation in service delivery. The cost-effectiveness of consumer-directed care will be evaluated by comparing incremental changes in resource use, costs and health and quality of life outcomes relative to traditional services. The discrete choice experiment will be repeated at the end of the implementation period to determine the extent to which attitudes and preferences change as a consequence of experience of consumer-directed care. The proposed framework will have wide applicability in the future development and economic evaluation of new innovations across the health and aged care sectors.
The study is approved by Flinders University Social and Behavioural Research Ethics Committee (Project No. 6114/SBREC). Findings from the qualitative interviews, discrete choice experiments and the economic evaluation will be reported at a workshop of stakeholders to be held in 2015 and will be documented in reports and in peer reviewed journal articles.
消费者导向型护理目前在澳大利亚乃至国际上都受到广泛认可，被视为一种在提供健康和老年护理服务时促进自主性和选择权的方式。尽管其广泛传播，但迄今为止，几乎没有开展研究来评估老年人对消费者导向型护理的看法和偏好，也没有评估这种方法相对于现有服务提供模式的成本和收益。
将开发一个全面的健康经济模型，并应用于澳大利亚社区老年护理环境中消费者导向型护理的演变、实施和评估。一种包括定性访谈和离散选择实验的混合方法，将确定老年人及其非正式护理人员对消费者导向型护理的态度和偏好。定性访谈和离散选择实验的结果将为服务提供中引入新的消费者导向型护理创新提供依据。通过比较相对于传统服务在资源使用、成本以及健康和生活质量结果方面的增量变化，来评估消费者导向型护理的成本效益。在实施期结束时将重复进行离散选择实验，以确定由于消费者导向型护理的体验，态度和偏好发生变化的程度。所提出的框架将在健康和老年护理部门新创新的未来发展和经济评估中具有广泛的适用性。
该研究已获得弗林德斯大学社会与行为研究伦理委员会批准（项目编号6114/SBREC）。定性访谈、离散选择实验和经济评估的结果将在2015年举行的利益相关者研讨会上报告，并将记录在报告和同行评审的期刊文章中。
