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基于离散选择实验的北京市社区重度精神障碍患者护理服务偏好分析

Analysis on Care Service Preferences of Community Patients With Severe Mental Disorders in Beijing Based on Discrete Choice Experiment.

作者信息

Zhu Jin-Qi, Lu Wei, Xin Yu, Chen Yun, Huang Qing-Zhi, Zhu Jun-Li

机构信息

School of Public Health,Capital Medical University,Beijing 100069,China.

Beijing Institute of Mental Health,Beijing 100088,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2025 Jun 30;47(3):425-433. doi: 10.3881/j.issn.1000-503X.16281.

Abstract

Objective To gain insights into the care service preferences and willingness of patients with severe mental disorders in Beijing,analyze the main factors affecting their participation in care services,and provide data support and decision-making reference for the optimal design of care services for patients with severe mental disorders and the improvement of relevant policies.Methods In July 2022,a questionnaire survey was conducted for a part of Beijing community patients with severe mental disorders selected by multi-stage stratified sampling,including the basic personal information and the preferences of discrete choice experiment.A mixed Logit model was used to perform regression analysis on the care service preferences,and the trade off between general and monetary attributes was quantified by willingness to pay(WTP).Results A total of 242 questionnaires were distributed,and 181 valid questionnaires were collected,with a response rate of 74.79%.The regression coefficients for the four attributes-service type,service content,service frequency,and service cost-all showed statistical significance(all <0.05).Patients' most preferred attribute level was a service frequency covering about 90% of the time per month/year( β=1.059),while the least preferred was full-time residential care( β=-1.025).Increasing the service frequency from 30% to 90% corresponded to a WTP of 492.5 yuan,while changing the service type from home-based care to full-time residential care resulted in a WTP of -476.6 yuan.Moreover,there were differences in care service preferences and WTP among patient groups with different characteristics(all <0.05).Conclusions Service type,service content,service frequency,and service cost all significantly affect the care service preferences of patients with severe mental disorders.There is heterogeneity in care service preferences among patient groups with different characteristics.

摘要

目的 了解北京市重性精神障碍患者的照护服务偏好与意愿,分析影响其参与照护服务的主要因素,为优化重性精神障碍患者照护服务设计及完善相关政策提供数据支持与决策参考。方法 2022年7月,采用多阶段分层抽样方法对北京市部分社区重性精神障碍患者进行问卷调查,内容包括基本个人信息及离散选择实验偏好。采用混合Logit模型对照护服务偏好进行回归分析,通过支付意愿(WTP)量化一般属性与货币属性之间的权衡。结果 共发放问卷242份,回收有效问卷181份,有效回收率为74.79%。服务类型、服务内容、服务频次、服务成本4个属性的回归系数均有统计学意义(均P<0.05)。患者最偏好的属性水平是每月/每年约90%时间的服务频次(β=1.059),最不偏好的是全日制住院照护(β=-1.025)。服务频次从30%提高到90%对应的WTP为492.5元,服务类型从居家照护改为全日制住院照护导致的WTP为-476.6元。此外,不同特征患者组在照护服务偏好和WTP方面存在差异(均P<0.05)。结论 服务类型、服务内容、服务频次、服务成本均显著影响重性精神障碍患者的照护服务偏好。不同特征患者组在照护服务偏好方面存在异质性。

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