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乳腺癌患者对过渡性护理的偏好及支付意愿:一项离散选择实验

Patient preferences and willingness to pay for transitional care in breast cancer: a discrete choice experiment.

作者信息

Zhu Wenjuan, Cui Liping, Yang Hui, Guo Jun, Gao Jinnan, An Yuan, Yang Xiaomin, Li Wanling, Wang Ying

机构信息

Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.

Nursing School, Shanxi Medical University, Taiyuan, 030001, China.

出版信息

Support Care Cancer. 2025 Feb 13;33(3):185. doi: 10.1007/s00520-025-09184-4.

Abstract

PURPOSE

Most chemotherapy reactions occur outside of the hospital; therefore, providing transitional care (TC) to patients is essential. However, patients' preferences for TC remain poorly understood. This study aims to investigate the preferences and willingness to pay for TC among breast cancer patients.

METHODS

Data were collected using a discrete choice experiment from a large general hospital in North China. The study used six attributes to describe the preferences of patients for TC. Conditional logit and mixed logit models were applied to assess patient preferences, estimate willingness to pay, and simulate uptake probabilities across different scenarios.

RESULTS

A total of 261 respondents completed the survey. The study showed that patients strongly preferred a TC to be provided by a specialist doctor and specialist nurse (β = 0.925; p < 0.001) and were willing to pay CNY¥105.381. The service content most preferred was symptom management, psychological care, and rehabilitation guidance (β = 0.286; p < 0.001), and patients were willing to pay CNY¥32.606. The forms of services most preferred were at outpatient clinics (β = 0.239; p < 0.001), and patients were willing to pay CNY¥27.285. Low out-of-pocket expense was preferred by patients (β = - 0.009; p < 0.001). When TC was provided by a specialist doctor and specialist nurse in an outpatient clinic in conjunction with multidimensional care services and out-of-pocket payment of CNY¥20 per visit, the probability of breast cancer patients' participation increased to 91.39%.

CONCLUSION

The results of this study suggest that breast cancer patients have strong preferences for the provider, content, and form of transitional care (TC), as well as for minimizing out-of-pocket costs.

摘要

目的

大多数化疗反应发生在医院之外;因此,为患者提供过渡性护理(TC)至关重要。然而,患者对过渡性护理的偏好仍知之甚少。本研究旨在调查乳腺癌患者对过渡性护理的偏好及支付意愿。

方法

采用离散选择实验,从中国北方一家大型综合医院收集数据。该研究使用六个属性来描述患者对过渡性护理的偏好。应用条件逻辑模型和混合逻辑模型来评估患者偏好、估计支付意愿,并模拟不同场景下的接受概率。

结果

共有261名受访者完成了调查。研究表明,患者强烈倾向于由专科医生和专科护士提供过渡性护理(β = 0.925;p < 0.001),且愿意支付105.381元人民币。最受青睐的服务内容是症状管理、心理护理和康复指导(β = 0.286;p < 0.001),患者愿意支付32.606元人民币。最受青睐的服务形式是门诊(β = 0.239;p < 0.001),患者愿意支付27.285元人民币。患者更喜欢低自付费用(β = -0.009;p < 0.001)。当由专科医生和专科护士在门诊提供过渡性护理,并结合多维护理服务且每次自付费用为20元人民币时,乳腺癌患者参与的概率增至91.39%。

结论

本研究结果表明,乳腺癌患者对过渡性护理的提供者(TC)、内容、形式以及将自付费用降至最低有着强烈的偏好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7ad/11821795/250ae73ce674/520_2025_9184_Fig1_HTML.jpg

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