Yang Jin, Ma Bingxin, Chen Shixiang, Huang Yaqi, Wang Yulu, Chen Ying, Zhang Xiaojun, Ma Tingting, Zhao Yue, Wang Yaogang, Lu Qi
School of Nursing, Tianjin Medical University, Tianjin 300070, China.
School of Nursing, Shandong Second Medical University, Weifang 261053, China.
Int J Nurs Stud. 2025 Jan;161:104920. doi: 10.1016/j.ijnurstu.2024.104920. Epub 2024 Oct 1.
China's 'Internet Plus' nursing services, which are Uber-style home care services with an 'online application, offline service' approach, have been evolving over the past five years. Registered nurses' preference for these Uber-style Internet Plus nursing services are crucial for improving human resource management and service efficiency, yet research in this area remains scarce.
This study aimed to explore registered nurses' preferences for Uber-style Internet Plus nursing services and provide optimization recommendations from a supply-side perspective.
A cross-sectional study utilising a discrete choice experiment.
SETTING(S): Two public tertiary hospitals located in Tianjin, China, which have implemented Internet Plus nursing services.
211 registered nurses who participated in Internet Plus nursing services.
The survey was conducted anonymously using an online survey platform. Respondents were presented with choices between two alternatives, based on five key attributes: income, safety and security, patient and family cooperation, commute time, and service type. Mixed logit models estimated the stated preferences for attributes. Relative importance scores, willingness-to-pay estimates, and simulations of service-type uptake rates were calculated. Subgroup analysis and seemingly unrelated regression estimation were performed to examine heterogeneity in preferences.
A total of 3202 choice observations were generated. When sorted by the strength of preference, the five attributes related to registered nurses' choice of Uber-style Internet Plus nursing services, measured by their relative importance scores, are as follows: safety and security (30.89 %), income (27.41 %), patient and family cooperation (18.47 %), service type (11.96 %), and commuting time (11.27 %). Elevating safety and security from low to high levels has the same utility as a 31.81 % increase in monthly income, equivalent to 2586.14 yuan. Subgroup analysis showed that senior nurses place more value on safety and security than junior nurses (β = 1.421 vs.β = 0.725; P = 0.011), and unmarried nurses had a stronger preference for family and caregiver cooperation (β = 1.105 vs.β = 0.314; P = 0.023).
The strength and heterogeneity of registered nurses' preferences should be highlighted in the dispatch algorithms model of Uber-style Internet Plus nursing services, thereby enhancing the efficiency and humanity of Uber-style Internet Plus nursing services.
Registered nurses prioritise safety and security, acknowledging heterogeneous preferences in Uber-style Internet Plus nursing services.
中国的“互联网 +”护理服务采用“线上申请、线下服务”的模式，类似优步的居家护理服务，在过去五年中不断发展。注册护士对这些类似优步的“互联网 +”护理服务的偏好对于改善人力资源管理和服务效率至关重要，但该领域的研究仍然稀缺。
本研究旨在探讨注册护士对类似优步的“互联网 +”护理服务的偏好，并从供应方角度提供优化建议。
采用离散选择实验的横断面研究。
位于中国天津的两家实施了“互联网 +”护理服务的公立三级医院。
211名参与“互联网 +”护理服务的注册护士。
使用在线调查平台进行匿名调查。根据收入、安全保障、患者及家属配合度、通勤时间和服务类型这五个关键属性，向受访者提供两种选择之间的抉择。混合逻辑模型估计了对各属性的陈述偏好。计算了相对重要性得分、支付意愿估计值以及服务类型采用率模拟值。进行了亚组分析和看似不相关的回归估计，以检验偏好的异质性。
共产生了3202个选择观察值。按偏好强度排序，与注册护士选择类似优步的“互联网 +”护理服务相关的五个属性，以相对重要性得分衡量，如下所示：安全保障（30.89%）、收入（27.41%）、患者及家属配合度（18.47%）、服务类型（11.96%）和通勤时间（11.27%）。将安全保障从低水平提高到高水平与月收入增加31.81%具有相同的效用，相当于增加2586.14元。亚组分析表明，资深护士比初级护士更看重安全保障（β = 1.421对β = 0.725；P = 0.011），未婚护士对家庭及护理人员配合度的偏好更强（β = 1.105对β = 0.314；P = 0.023）。
在类似优步的“互联网 +”护理服务的调度算法模型中，应突出注册护士偏好的强度和异质性，从而提高类似优步的“互联网 +”护理服务的效率和人性化程度。
注册护士将安全保障列为优先事项，承认在类似优步的“互联网 +”护理服务中存在异质性偏好。
