Department of Health Management and Economics, Health Policy & Management Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Department of Health Management and Economics, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran.
PLoS One. 2024 Oct 17;19(10):e0293241. doi: 10.1371/journal.pone.0293241. eCollection 2024.
Individual preferences have preceded the use of health care services, and it has been affected by different hospital attributes. This study aimed to elicit the Iranians' preferences in choosing hospitals using a discrete choice experiment.
A discrete choice experiment (DCE) was conducted through face to face interviews with 301 participants. The DCE was constructed by six attributes were included based on a literature review, qualitative interviews, Focus Group Discussion (FGD) and consensus development approach: waiting time, quality of care, travel time, hospital type, provider competency, and hospital facilities. individuals' preferences for hospital attributes were analyzed using a mixed logit model, and interaction terms were used to assess preference heterogeneity among individuals with different sociodemographic characteristics.
Participants had strong and significant preferences for care delivered in hospitals with 'full' (β = 0.6052, p<0.001) or 'moderate' (β = 0.5882, p<0.001) hospital equipment and with 'excellent' provider competency (β = 0.2637, p<0.001). The estimated coefficients for the "waiting time of 120 minutes" (β = -0.1625, p<0.001) and the "travel time of 30 minutes" (β = -0.1157, p<0.001) were negative and significant. The results also show that the personal characteristics such as age, education level, and income significantly affected individual preferences in choosing a hospital.
Considering people's preferences can be important given the more active role of today's patients in decision-making about their treatment processes. The results of this study should be taken into consideration by health policymakers and all stakeholders to be aware of differences in preferences of people and maximize their satisfaction. In this case, it is important to continuously involve people and consider their preferences in the design, topology, construction, and equipment of hospitals.
个人偏好先于医疗服务的使用，并且受到不同医院属性的影响。本研究旨在通过离散选择实验（DCE）来确定伊朗人选择医院的偏好。
通过对 301 名参与者进行面对面访谈，进行了离散选择实验（DCE）。DCE 的构建是基于文献回顾、定性访谈、焦点小组讨论（FGD）和共识开发方法，包括 6 个属性：等待时间、护理质量、旅行时间、医院类型、提供者能力和医院设施。使用混合 logit 模型分析个体对医院属性的偏好，并使用交互项评估具有不同社会人口特征的个体之间的偏好异质性。
参与者对具有“完全”（β=0.6052，p<0.001）或“中等”（β=0.5882，p<0.001）医院设备和“优秀”提供者能力的医院提供的护理有强烈且显著的偏好。“等待时间 120 分钟”（β=-0.1625，p<0.001）和“旅行时间 30 分钟”（β=-0.1157，p<0.001）的估计系数为负且显著。结果还表明，年龄、教育程度和收入等个人特征显著影响个体选择医院的偏好。
考虑到今天的患者在决定治疗过程方面发挥着更积极的作用，因此考虑人们的偏好可能很重要。卫生政策制定者和所有利益相关者都应考虑本研究的结果，了解人们偏好的差异，并最大限度地提高他们的满意度。在这种情况下，重要的是要不断让人们参与进来，并在医院的设计、拓扑结构、建设和设备中考虑他们的偏好。
