Yale School of Medicine, New Haven, Connecticut, USA
Uganda Initiative for Integrated Management of Non-communicable Diseases, Kampala, Uganda.
BMJ Open. 2022 Jul 21;12(7):e059949. doi: 10.1136/bmjopen-2021-059949.
To explore how respondents with common chronic conditions-hypertension (HTN) and diabetes mellitus (DM)-make healthcare-seeking decisions.
Three health facilities in Nakaseke District, Uganda.
Discrete choice experiment (DCE).
496 adults with HTN and/or DM.
Willingness to pay for changes in DCE attributes: getting to the facility, interactions with healthcare providers, availability of medicines for condition, patient peer-support groups; and education at the facility.
Respondents were willing to pay more to attend facilities that offer peer-support groups, friendly healthcare providers with low staff turnover and greater availabilities of medicines. Specifically, we found the average respondent was willing to pay an additional 77 121 Ugandan shillings (UGX) for facilities with peer-support groups over facilities with none; and 49 282 UGX for 1 month of medicine over none, all other things being equal. However, respondents would have to compensated to accept facilities that were further away or offered health education. Specifically, the average respondent would have to be paid 3929 UGX to be willing to accept each additional kilometre they would have to travel to the facilities, all other things being equal. Similarly, the average respondent would have to be paid 60 402 UGX to accept facilities with some health education, all other things being equal.
Our findings revealed significant preferences for health facilities based on the availability of medicines, costs of treatment and interactions with healthcare providers. Understanding patient preferences can inform intervention design to optimise healthcare service delivery for patients with HTN and DM in rural Uganda and other low-resource settings.
探索患有常见慢性病（高血压和糖尿病）的患者如何做出医疗保健决策。
乌干达纳卡塞克区的 3 个卫生机构。
离散选择实验（DCE）。
496 名患有高血压和/或糖尿病的成年人。
对 DCE 属性变化的支付意愿：到达医疗机构、与医疗保健提供者的互动、有条件获得药物、患者同伴支持小组以及机构内的教育。
患者愿意为参加提供同伴支持小组、友善的医护人员（人员流动率低）、更多药物供应的医疗机构支付更多费用。具体而言，我们发现，平均而言，患者愿意为有同伴支持小组的医疗机构支付比没有的医疗机构额外 77121 乌干达先令（UGX）；愿意为有 1 个月药物供应的医疗机构支付比没有的医疗机构额外 49282UGX，其他条件不变。然而，患者必须得到补偿才能接受更远或提供健康教育的医疗机构。具体而言，平均而言，在其他条件不变的情况下，患者必须获得 3929UGX 的补偿，才能愿意接受他们必须多走的每一公里前往医疗机构。同样，在其他条件不变的情况下，平均而言，患者必须获得 60402UGX 的补偿，才能接受提供一些健康教育的医疗机构。
我们的研究结果表明，患者对医疗机构有显著的偏好，这些偏好取决于药物的可获得性、治疗费用和与医疗保健提供者的互动。了解患者的偏好可以为干预措施的设计提供信息，以优化乌干达农村和其他资源匮乏地区高血压和糖尿病患者的医疗服务提供。
