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离散选择实验在确定国家医疗保健相关感染监测计划偏好方面的新应用:一项横断面研究。

Novel application of a discrete choice experiment to identify preferences for a national healthcare-associated infection surveillance programme: a cross-sectional study.

作者信息

Russo Philip L, Chen Gang, Cheng Allen C, Richards Michael, Graves Nicholas, Ratcliffe Julie, Hall Lisa

机构信息

Institute of Health and Biomedical Innovation, School of Public Health and Welfare, Queensland University of Technology, Kelvin Grove, Queensland, Australia School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia.

Flinders Health Economics Group, School of Medicine, Flinders University, Repatriation General Hospital, Daw Park, South Australia, Australia.

出版信息

BMJ Open. 2016 May 4;6(5):e011397. doi: 10.1136/bmjopen-2016-011397.

Abstract

OBJECTIVE

To identify key stakeholder preferences and priorities when considering a national healthcare-associated infection (HAI) surveillance programme through the use of a discrete choice experiment (DCE).

SETTING

Australia does not have a national HAI surveillance programme. An online web-based DCE was developed and made available to participants in Australia.

PARTICIPANTS

A sample of 184 purposively selected healthcare workers based on their senior leadership role in infection prevention in Australia.

PRIMARY AND SECONDARY OUTCOMES

A DCE requiring respondents to select 1 HAI surveillance programme over another based on 5 different characteristics (or attributes) in repeated hypothetical scenarios. Data were analysed using a mixed logit model to evaluate preferences and identify the relative importance of each attribute.

RESULTS

A total of 122 participants completed the survey (response rate 66%) over a 5-week period. Excluding 22 who mismatched a duplicate choice scenario, analysis was conducted on 100 responses. The key findings included: 72% of stakeholders exhibited a preference for a surveillance programme with continuous mandatory core components (mean coefficient 0.640 (p<0.01)), 65% for a standard surveillance protocol where patient-level data are collected on infected and non-infected patients (mean coefficient 0.641 (p<0.01)), and 92% for hospital-level data that are publicly reported on a website and not associated with financial penalties (mean coefficient 1.663 (p<0.01)).

CONCLUSIONS

The use of the DCE has provided a unique insight to key stakeholder priorities when considering a national HAI surveillance programme. The application of a DCE offers a meaningful method to explore and quantify preferences in this setting.

摘要

目的

通过使用离散选择实验(DCE),确定在考虑国家医疗保健相关感染(HAI)监测计划时关键利益相关者的偏好和优先事项。

背景

澳大利亚没有国家HAI监测计划。开发了一个基于网络的在线DCE,并提供给澳大利亚的参与者。

参与者

基于他们在澳大利亚感染预防方面的高级领导角色,有目的地选择了184名医护人员作为样本。

主要和次要结果

一个DCE要求受访者在重复的假设情景中,根据5个不同特征(或属性)从另一个HAI监测计划中选择1个。使用混合逻辑模型分析数据,以评估偏好并确定每个属性的相对重要性。

结果

在5周内,共有122名参与者完成了调查(回复率66%)。排除22名在重复选择情景中不匹配的参与者后,对100份回复进行了分析。主要发现包括:72%的利益相关者倾向于一个具有持续强制性核心组成部分的监测计划(平均系数0.640(p<0.01)),65%倾向于一个收集感染和未感染患者患者层面数据的标准监测方案(平均系数0.641(p<0.01)),92%倾向于在网站上公开报告且与经济处罚无关的医院层面数据(平均系数1.663(p<0.01))。

结论

DCE的使用为考虑国家HAI监测计划时关键利益相关者的优先事项提供了独特的见解。DCE的应用提供了一种有意义的方法来探索和量化这种情况下的偏好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d70/4861107/ce7de4e9670c/bmjopen2016011397f01.jpg

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