WITHDRAWN Exploring Preference Heterogeneity of the Older Swiss Population Towards Innovations in Healthcare Delivery Models Using Latent Class Analysis

OBJECTIVES: Reforming the healthcare system with “one size fits all” recommendations may be counterproductive, and therefore diminish acceptability and impact of suggested policy changes. Better understanding preference heterogeneity in the target population should be more systematically accounted for in policy design. In this project, we aim to explore heterogeneity of preferences towards care delivery models in the Swiss older population, and to understand which subgroups are more open to changes in healthcare policy aimed at better-coordinated care.

METHODS: A DCE (discrete choice experiment) was developed following the best practices and involving key stakeholders. To investigate preference heterogeneity within the DCE, we estimated a latent class logit model, which is used to identify qualitatively different subgroups (classes) within populations who often share certain characteristics. Next, we examined which background characteristics were associated with the probability of a certain class membership using multinomial logit model.

RESULTS: The model was optimized with three classes, with the following distribution of respondents: class 1 (49%), class 2 (19%) and class 3 (32%). Class 1 members were in favor of more integrated care structures where care is not managed by one GP only, but rather by a team of professionals. Individuals in class 2 were younger, higher educated and with more radical views on the Swiss healthcare, and open to reforms. Class 3 respondents (oldest, less wealthy, lower educated) showed reluctance for any attributes diverting from the current situation and contained 100% of status quo choosers.

CONCLUSIONS: Distinguishing three distinct groups helped to understand the profiles of the population generally accepting reforms, those open to certain specific changes in healthcare, and the profiles of population who prefer no changes at all. The communication approach and development of the potential reforms may be implemented step-wise, tailored to the preferences of several major groups.