Health Economics Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
Division of Rural Health and Wellbeing, Centre for Health Science, University of the Highlands and Islands, Inverness, IV2 3JH, UK.
Patient. 2024 Nov;17(6):663-672. doi: 10.1007/s40271-024-00704-8. Epub 2024 Jul 16.
Pregnant women living in rural areas considering their preferred place of birth may have to 'trade-off' travel time/distance and other attributes of care (e.g. the full choice of birthplace options is rarely available locally). This study assesses the preferences and trade-offs of recent mothers who live in remote and rural areas of Great Britain.
An online survey, informed by qualitative research, was administered to women living in rural areas who had given birth in the preceding 3 years. The survey included a discrete choice experiment (DCE) to elicit women's preferences and trade-offs for place of birth. The DCE presented women with a series of eight choice tasks in which place of birth was defined by four attributes: (1) type of facility, (2) familiarity with staff, (3) understanding options and feel relaxed and reassured and (4) the travel time to the place of intrapartum care. DCE data were analysed using an error components logit model to identify preferences.
Across 251 survey responses, holding everything else equal, respondents preferred: intrapartum care in locations with more specialist staff and equipment, locations where they understood their options and felt reassured and where travel time was minimal. Women were willing to travel (92-183 min) to a well-staffed and equipped facility if they understood their options and felt relaxed and reassured. Willingness to travel was reduced if the care received at the specialist facility was such that they did not understand their options and felt tense and powerless (41-132 min).
These insights into the preferences of recent mums from remote and rural areas could inform future planning of rural intrapartum care.
考虑到首选分娩地点，居住在农村地区的孕妇可能不得不“权衡”出行时间/距离和其他护理属性（例如，当地很少有完整的分娩地点选择）。本研究评估了居住在英国偏远和农村地区的近期产妇的偏好和权衡。
一项基于定性研究的在线调查针对在过去 3 年内分娩的居住在农村地区的妇女进行。该调查包括一项离散选择实验（DCE），以了解妇女对分娩地点的偏好和权衡。DCE 通过四个属性定义分娩地点：（1）设施类型，（2）对员工的熟悉程度，（3）了解选择和感到放松和放心，（4）前往分娩时护理地点的旅行时间。使用误差成分对数模型分析 DCE 数据以确定偏好。
在 251 份调查回复中，在其他条件相同的情况下，受访者更喜欢：具有更多专业人员和设备的分娩地点、他们了解自己的选择并感到放心且旅行时间最短的地点。如果女性了解自己的选择并感到放松和放心，她们愿意前往配备齐全的设施（92-183 分钟）。如果在专业设施中接受的护理使她们无法了解自己的选择并且感到紧张和无能为力，那么她们愿意旅行的意愿就会降低（41-132 分钟）。
这些来自偏远和农村地区的近期产妇偏好的见解可以为未来农村分娩护理的规划提供信息。
