Liu Yaqing, Du Sixian, Liu Chaojie, Xue Tianqin, Tang Yuqing
School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Public Health, La Trobe University, Melbourne, VIC, Australia.
Front Public Health. 2024 Apr 18;12:1324776. doi: 10.3389/fpubh.2024.1324776. eCollection 2024.
This research, utilizing discrete choice experiments, examines the preferences and willingness to pay for home-based healthcare and support services among residents in China, a country grappling with severe aging population, an area often underexplored in international scholarship.
This study aims to solicit the preferences of primary care patients for home-based healthcare and support services in China.
A discrete choice experiment (DCE) was conducted on 312 primary care patients recruited from 13 community health centers in Wuhan and Kunming between January and May 2023. The experimental choice sets were generated using NGene, covering five attributes: Scope of services, health professionals, institutions, insurance reimbursements, and visiting fees.
The choice sets were further divided into three blocks, and each participant was asked to complete one block containing 12 choice tasks. Mixed logit models were established to estimate the relevant importance coefficients of and willingness to pay for different choices, while Latent Class Logit (LCL) modeling was conducted to capture possible preferences heterogeneity.
The relevant importance of the scope of services reached 67.33%, compared with 19.84% for service institutions and 12.42% for health professionals. Overall, respondents preferred physician-led diagnostic and treatment services. LCL categorized the respondents into three groups: Group one (60.20%) was most concerned about the scope of services, prioritizing disease diagnosis and treatment over preventive care and mental health, while group two (16.60%) was most concerned about care providers (hospitals and medical doctors were preferred), and group three (23.20%) was most concerned about financial burdens.
Primary care patients prefer physical health and medical interventions for home-based healthcare and support services. However, heterogeneity in preferences is evident, indicating potential disparities in healthcare and support at home services in China.
本研究利用离散选择实验，考察了在中国这个正应对严重老龄化人口问题、且在国际学术研究中常被忽视的领域中，居民对居家医疗保健和支持服务的偏好及支付意愿。
本研究旨在征求中国基层医疗患者对居家医疗保健和支持服务的偏好。
设计、地点和参与者：2023年1月至5月，对从武汉和昆明的13个社区卫生中心招募的312名基层医疗患者进行了离散选择实验。实验选择集使用NGene生成，涵盖五个属性：服务范围、医疗专业人员、机构、保险报销和出诊费用。
选择集进一步分为三个模块，要求每位参与者完成一个包含12个选择任务的模块。建立混合逻辑模型以估计不同选择的相关重要系数和支付意愿，同时进行潜在类别逻辑（LCL）建模以捕捉可能的偏好异质性。
服务范围的相关重要性达到67.33%，而服务机构为19.84%，医疗专业人员为12.42%。总体而言，受访者更喜欢由医生主导的诊断和治疗服务。LCL将受访者分为三组：第一组（60.20%）最关注服务范围，将疾病诊断和治疗置于预防保健和心理健康之上；第二组（16.60%）最关注护理提供者（更喜欢医院和医生）；第三组（23.20%）最关注经济负担。
基层医疗患者在居家医疗保健和支持服务方面更喜欢身体健康和医疗干预。然而，偏好的异质性很明显，这表明中国居家医疗保健和支持服务可能存在差异。
