PATIENT-CENTERED HEALTH CARE DELIVERY SYSTEMS- A DISCRETE CHOICE EXPERIMENT

Author(s)

Mühlbacher AC1, Bethge S1, Schulman K21Duke University, Durham, NC, USA, 2Duke Clinical Research Institute, Durham, NC, USA

OBJECTIVES: Patient-centered care, in which health services are customized on the basis of patients’ needs and values, is seen as a critical factor in a high-performance health care system. This project seeks to characterize patients’ needs and values for specific features of health care delivery systems. METHODS: Quantitative data were obtained by means of a discrete choice experiment (DCE). Alternatives were described by specific attributes that described certain features of a health care delivery system. Each set included six attributes with three specific levels. The DCE was divided into four blocks based on thematic mapping (DCE 1, patient involvement; DCE 2, point of care; DCE 3, personnel; DCE 4, organization). RESULTS:  In preliminary results, N=663 respondents have completed the survey so far. The feature “out-of-pocket costs” was the most important attribute across all 4 DCEs (DCE 1 coefficient, 0.59025; DCE 2 coefficient, 1.20715; DCE 3 coefficient, 0.99938. DCE 4 coefficient, 0.99079). In DCE 1 regarding patient involvement, “trust and respect” (0.50411) and “attention to personal situation” (0.33664) were of greatest importance. In DCE 2 addressing preferences at the point of care, “shared decision making” (0.77153) and “access to patient record” (0.51370) were nearly equally valuable to patients but of highest relevance. In DCE 3 focusing on personnel in health care delivery systems, “multidisciplinary care” (0.74468) was ranked highest. Lastly, in DCE 4 analyzing features of the organization of health care delivery systems, “travel time” (0.39266), “medical devices and furnishings” (0.41689), and “treatment guidelines” (0.41566) were of almost equal value to patients. CONCLUSIONS: The study is intended to close the gap between simplistic representations of patient preferences in today’s health care systems and the complexity of actual patient decision-making processes by using the specification and explanatory power of DCEs.

Conference/Value in Health Info

2011-11, ISPOR Europe 2011, Madrid, Spain

Value in Health, Vol. 14, No. 7 (November 2011)

Code

PHP87

Topic

Health Service Delivery & Process of Care

Topic Subcategory

Hospital and Clinical Practices

Disease

Multiple Diseases

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