Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
Eur J Health Econ. 2018 Dec;19(9):1213-1223. doi: 10.1007/s10198-018-0968-0. Epub 2018 Apr 6.
Most people prefer to "age in place" and to remain in their homes for as long as possible even in case they require long-term care. While informal care is projected to decrease in Germany, the use of home- and community-based services (HCBS) can be expected to increase in the future. Preference-based data on aspects of HCBS is needed to optimize person-centered care.
To investigate preferences for home- and community-based long-term care services packages.
Discrete choice experiment conducted in mailed survey.
Randomly selected sample of the general population aged 45-64 years in Germany (n = 1.209).
Preferences and marginal willingness to pay (WTP) for HCBS were assessed with respect to five HCBS attributes (with 2-4 levels): care time per day, service level of the HCBS provider, quality of care, number of different caregivers per month, co-payment.
Quality of care was the most important attribute to respondents and small teams of regular caregivers (1-2) were preferred over larger teams. Yet, an extended range of services of the HCBS provider was not preferred over a more narrow range. WTP per hour of HCBS was €8.98.
Our findings on preferences for HCBS in the general population in Germany add to the growing international evidence of preferences for LTC. In light of the great importance of high care quality to respondents, reimbursement for services by HCBS providers could be more strongly linked to the quality of services.
大多数人希望“原地老化”，并尽可能长时间地留在自己的家中，即使他们需要长期护理。尽管德国的非正式护理预计会减少，但未来对家庭和社区为基础的服务（HCBS）的使用预计会增加。需要基于偏好的 HCBS 方面的数据，以优化以患者为中心的护理。
调查对家庭和社区长期护理服务包的偏好。
在邮寄调查中进行离散选择实验。
德国随机选择的 45-64 岁普通人群样本（n=1209）。
使用五个 HCBS 属性（2-4 个水平）评估 HCBS 的偏好和边际支付意愿（WTP）：每天的护理时间、HCBS 提供者的服务水平、护理质量、每月不同护理人员的数量、共同支付。
护理质量是受访者最重要的属性，小团队的常规护理人员（1-2 人）比大团队更受欢迎。然而，HCBS 提供者提供的广泛服务范围并不比更窄的范围更受欢迎。HCBS 每小时的 WTP 为 8.98 欧元。
我们在德国普通人群中对 HCBS 的偏好研究结果补充了国际上关于长期护理偏好的不断增加的证据。鉴于受访者对高护理质量的高度重视，HCBS 提供者的服务报销可以更紧密地与服务质量挂钩。
