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你愿意和你的医生视频吗?一项识别德国初级保健中患者对视频和门诊咨询偏好的离散选择实验。

Would you zoom with your doctor? A discrete choice experiment to identify patient preferences for video and in-clinic consultations in German primary care.

机构信息

Rotterdam School of Management, Erasmus University Rotterdam, The Netherlands.

Erasmus School of Health Policy and Management, Erasmus University Rotterdam, The Netherlands.

出版信息

J Telemed Telecare. 2024 Jul;30(6):969-992. doi: 10.1177/1357633X221111975. Epub 2022 Aug 2.

Abstract

INTRODUCTION

The popularity of video consultations in healthcare has accelerated during the COVID-19 pandemic. Despite increased availability and obvious benefits, many patients remain hesitant to use video consultations. This study investigates the relative importance of the consultation mode compared to other attributes in patients' appointment choices in Germany.

METHODS

A discrete choice experiment was conducted to examine the influence of appointment attributes on preferences for video over in-clinic consultations. A total of 350 participants were included in the analysis.

RESULTS

The level of continuity of care (46%) and the waiting time until the next available appointment (22%) were shown to have higher relative importance than consultation mode (18%) and other attributes. Participants with fewer data privacy concerns, higher technology proficiency, and more fear of COVID-19 tended to prefer video over in-clinic consultations. The predicted choice probability of a video over a typical in-clinic consultation and opting out increased from <1% to 40% when the video consultation was improved from the worst-case to the best-case scenario.

CONCLUSION

This study provides insight into the effect of the consultation mode on appointment choice at a time when telemedicine gains momentum. The results suggest that participants preferred in-clinic over video consultations. Policymakers and service providers should focus on increasing the level of continuity of care and decreasing the time until the next available appointment to prompt the adoption of video consultations. Although participants preferred to talk to their physician in person over consulting via video per se, the demand for video consultations can be increased significantly by improving the other appointment attributes of video consultations such as the level of continuity of care.

摘要

引言

在 COVID-19 大流行期间,医疗保健领域的视频咨询迅速普及。尽管可用性增加且明显受益,但许多患者仍然对使用视频咨询犹豫不决。本研究调查了在德国,与其他属性相比,咨询模式在患者预约选择中的相对重要性。

方法

采用离散选择实验研究预约属性对患者选择视频咨询而非门诊咨询的偏好的影响。共有 350 名参与者参与了分析。

结果

研究表明,连续护理水平(46%)和下一个可用预约的等待时间(22%)比咨询模式(18%)和其他属性具有更高的相对重要性。数据隐私问题较少、技术熟练程度较高、对 COVID-19 恐惧程度较高的参与者更倾向于选择视频咨询而非门诊咨询。当视频咨询从最差情况改善到最佳情况时,视频相对于典型门诊咨询的预测选择概率和选择退出的概率从<1%增加到 40%。

结论

本研究深入了解了在远程医疗势头强劲的当下,咨询模式对预约选择的影响。结果表明,参与者更倾向于选择门诊咨询而非视频咨询。政策制定者和服务提供商应专注于提高连续护理水平并减少下一个可用预约的时间,以促进视频咨询的采用。尽管参与者更愿意亲自与医生交谈而不是通过视频咨询,但通过改善视频咨询的其他预约属性(如连续护理水平),可以显著增加对视频咨询的需求。

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