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一项用于引出澳大利亚昆士兰州慢性病筛查项目偏好的离散选择实验。

A discrete choice experiment to elicit preferences for a chronic disease screening programme in Queensland, Australia.

作者信息

Senanayake S, Barnett A, Brain D, Allen M, Powell E E, O'Beirne J, Valery P, Hickman I J, Kularatna S

机构信息

Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia; Health Services and Systems Research, Duke-NUS Medical School, Singapore.

Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia.

出版信息

Public Health. 2024 Mar;228:105-111. doi: 10.1016/j.puhe.2024.01.007. Epub 2024 Feb 13.

Abstract

OBJECTIVE

Patient-centred care, increasingly highlighted in healthcare strategies, necessitates understanding public preferences for healthcare service attributes. We aimed to understand the preferences of the Australian population regarding the attributes of chronic disease screening programmes.

STUDY DESIGN

The preferences were elicited using the discrete choice experiment (DCE) methodology.

METHODS

A DCE was administered to a sample of the Australian general population. Respondents were asked to make choices, each offering two hypothetical screening scenarios defined by screening conduct, quality and accuracy of the test results, cost to the patient, wait time and source of information. Data were analysed using a panel mixed multinomial logit model.

RESULTS

A strong preference for highly accurate screening tests and nurse-led screenings at local health clinics was evident. They expressed disutility for waiting time and out-of-pocket costs but were indifferent about the source of information. Their preference for a nurse-led programme was highlighted by the fact that they were willing to pay $81 and $88 to get a nurse-led programme when they were offered a general practitioner-led and a specialist-led programme, respectively. Furthermore, they were willing to pay $32 to reduce a week of waiting time and $205 for a 95% accurate test compared to a 75% accurate test. Preferences remained consistent irrespective of the respondent's place of residence.

CONCLUSIONS

Our findings highlight the importance of diagnostic test accuracy and nurse-led service delivery in chronic disease screening programmes. These insights could guide the development of patient-centric services by enhancing test accuracy, reducing waiting times and promoting nurse-led care models.

摘要

目的

以患者为中心的护理在医疗保健策略中日益受到重视,这就需要了解公众对医疗服务属性的偏好。我们旨在了解澳大利亚人群对慢性病筛查项目属性的偏好。

研究设计

采用离散选择实验(DCE)方法来获取偏好。

方法

对澳大利亚普通人群样本进行DCE调查。要求受访者做出选择,每个选择提供两种假设的筛查方案,这些方案由筛查实施情况、检测结果的质量和准确性、患者费用、等待时间以及信息来源来定义。使用面板混合多项logit模型对数据进行分析。

结果

明显倾向于在当地健康诊所进行高度准确的筛查测试以及由护士主导的筛查。他们对等待时间和自付费用表示不满,但对信息来源无所谓。当分别提供由全科医生主导和专科医生主导的项目时,他们愿意分别支付81澳元和88澳元来选择由护士主导的项目,这突出了他们对护士主导项目的偏好。此外,与75%准确率的测试相比,他们愿意支付32澳元来减少一周的等待时间,支付205澳元来获得95%准确率的测试。无论受访者居住地点如何,偏好都保持一致。

结论

我们的研究结果突出了诊断测试准确性和护士主导的服务提供在慢性病筛查项目中的重要性。这些见解可通过提高测试准确性、减少等待时间和推广护士主导的护理模式来指导以患者为中心的服务发展。

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