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消费者最看重养老院的哪些特点?一项针对居民和家属的离散选择实验。

What Characteristics of Nursing Homes Are Most Valued by Consumers? A Discrete Choice Experiment with Residents and Family Members.

机构信息

Department of Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, South Australia, Australia; Cognitive Decline Partnership Centre, University of Sydney, Sydney, New South Wales, Australia; Institute for Choice, University of South Australia, Adelaide, South Australia, Australia.

Institute for Choice, University of South Australia, Adelaide, South Australia, Australia; Flinders Health Economics Group, Flinders University, Adelaide, South Australia, Australia.

出版信息

Value Health. 2018 Jul;21(7):843-849. doi: 10.1016/j.jval.2017.11.004. Epub 2017 Dec 6.

Abstract

OBJECTIVES

To generate a scoring algorithm weighted on the preferences of consumers for assessing the quality of care in nursing homes (i.e., aged care homes or institutions) in six key domains.

METHODS

A discrete choice experiment was undertaken with residents of nursing homes (n = 126) or family member proxies (n = 416) in cases where severe cognitive impairment precluded resident participation. Analysis was undertaken using conditional and mixed logit regression models to determine preferences for potential attributes.

RESULTS

The findings indicate that all six attributes investigated were statistically significant factors for participants. Feeling at home in the resident's own room was the most important characteristic to both residents and family members. Care staff being able to spend enough time with residents, feeling at home in shared spaces, and staff being very flexible in care routines were also characteristics identified as important for both groups. The results of the Swait-Louviere test rejected the null hypothesis that the estimated parameters between residents and family members were the same, indicating that data from these two groups could not be pooled to generate a single weighted scoring algorithm for the Consumer Choice Index-Six Dimension instrument. Preferences were therefore encapsulated to generate scoring algorithms specific to residents and family members.

CONCLUSIONS

This study provides important insights into the characteristics of nursing home care that are most valued by consumers. The Consumer Choice Index-Six Dimension instrument may be usefully applied in the evaluation, planning, and design of future services.

摘要

目的

生成一个基于消费者对养老院(即老年护理院或机构)护理质量评估偏好的评分算法,该算法涉及六个关键领域。

方法

采用离散选择实验,对养老院居民(n=126)或因严重认知障碍而无法参与的居民的家庭成员代表(n=416)进行调查。使用条件和混合对数回归模型分析来确定对潜在属性的偏好。

结果

研究结果表明,所有六个调查的属性都是参与者的统计显著因素。居民在自己房间里有宾至如归的感觉是居民和家庭成员最重要的特征。护理人员能够与居民共度足够的时间、在共用空间里有宾至如归的感觉以及工作人员在护理常规方面非常灵活,这些也是两个群体都认为重要的特征。斯维特-洛维检验的结果拒绝了居民和家庭成员之间估计参数相同的零假设,表明这两个群体的数据不能合并为消费者选择指数-六维工具的单一加权评分算法。因此,偏好被封装起来,为居民和家庭成员生成特定的评分算法。

结论

本研究深入了解了消费者最看重的养老院护理特征。消费者选择指数-六维工具可用于未来服务的评估、规划和设计。

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