What Do Iranians Value Most when Choosing a Hospital? Evidence from a Discrete Choice Experiment

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Oct 17

PMID 39418239

Authors

Mohammad Ranjbar

Mohammad Bazyar

Fatemeh Pahlevanshamsi

Blake Angell

Yibeltal Assefa

Affiliations

Soon will be listed here.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

References

OHara N . Eliciting Health Care Preferences With Discrete Choice Experiments. JAMA Netw Open. 2022; 5(4):e228794. DOI: 10.1001/jamanetworkopen.2022.8794. View

OMahony M, Hegarty J, McCarthy G . Women's help seeking behaviour for self discovered breast cancer symptoms. Eur J Oncol Nurs. 2010; 15(5):410-8. DOI: 10.1016/j.ejon.2010.10.011. View

Borah B . A mixed logit model of health care provider choice: analysis of NSS data for rural India. Health Econ. 2006; 15(9):915-32. DOI: 10.1002/hec.1166. View

Lendado T, Bitew S, Elias F, Samuel S, Assele D, Asefa M . Effect of hospital attributes on patient preference among outpatient attendants in Wolaita Zone, Southern Ethiopia: discrete choice experiment study. BMC Health Serv Res. 2022; 22(1):661. PMC: 9110630. DOI: 10.1186/s12913-022-07874-x. View

de Bekker-Grob E, Donkers B, Jonker M, Stolk E . Sample Size Requirements for Discrete-Choice Experiments in Healthcare: a Practical Guide. Patient. 2015; 8(5):373-84. PMC: 4575371. DOI: 10.1007/s40271-015-0118-z. View

Hole A . Modelling heterogeneity in patients' preferences for the attributes of a general practitioner appointment. J Health Econ. 2008; 27(4):1078-1094. DOI: 10.1016/j.jhealeco.2007.11.006. View

Liu Y, Kong Q, Wang S, Zhong L, van de Klundert J . The impact of hospital attributes on patient choice for first visit: evidence from a discrete choice experiment in Shanghai, China. Health Policy Plan. 2019; 35(3):267-278. PMC: 7152730. DOI: 10.1093/heapol/czz159. View

Liu T, Li S, Yang R, Liu S, Chen G . Job preferences of undergraduate nursing students in eastern China: a discrete choice experiment. Hum Resour Health. 2019; 17(1):1. PMC: 6318922. DOI: 10.1186/s12960-018-0335-3. View

Salampessy B, Ikkersheim D, Portrait F, Koolman X . Do patients' preferences prevail in hospital selection?: a comparison between discrete choice experiments and revealed hospital choice. BMC Health Serv Res. 2022; 22(1):1136. PMC: 9461248. DOI: 10.1186/s12913-022-08403-6. View

10.

Hvidberg L, Wulff C, Pedersen A, Vedsted P . Barriers to healthcare seeking, beliefs about cancer and the role of socio-economic position. A Danish population-based study. Prev Med. 2014; 71:107-13. DOI: 10.1016/j.ypmed.2014.12.007. View

11.

Habtom G, Ruys P . The choice of a health care provider in Eritrea. Health Policy. 2006; 80(1):202-17. DOI: 10.1016/j.healthpol.2006.02.012. View

12.

van den Broek-Altenburg E, Atherly A . Patient preferences for provider choice: a discrete choice experiment. Am J Manag Care. 2020; 26(7):e219-e224. DOI: 10.37765/ajmc.2020.43761. View

13.

Robyn P, Barnighausen T, Souares A, Savadogo G, Bicaba B, Sie A . Health worker preferences for community-based health insurance payment mechanisms: a discrete choice experiment. BMC Health Serv Res. 2012; 12:159. PMC: 3476436. DOI: 10.1186/1472-6963-12-159. View

14.

Soekhai V, de Bekker-Grob E, Ellis A, Vass C . Discrete Choice Experiments in Health Economics: Past, Present and Future. Pharmacoeconomics. 2018; 37(2):201-226. PMC: 6386055. DOI: 10.1007/s40273-018-0734-2. View

15.

Tembon A . Health care provider choice: the North West Province of Cameroon. Int J Health Plann Manage. 1996; 11(1):53-67. DOI: 10.1002/(SICI)1099-1751(199601)11:1<53::AID-HPM413>3.0.CO;2-A. View

16.

Darrudi A, Daroudi R, Yunesian M, Akbari Sari A . Public Preferences and Willingness to Pay for a COVID-19 Vaccine in Iran: A Discrete Choice Experiment. Pharmacoecon Open. 2022; 6(5):669-679. PMC: 9397161. DOI: 10.1007/s41669-022-00359-x. View

17.

Zhu J, Li J, Zhang Z, Li H, Cai L . Exploring determinants of health provider choice and heterogeneity in preference among outpatients in Beijing: a labelled discrete choice experiment. BMJ Open. 2019; 9(4):e023363. PMC: 6500246. DOI: 10.1136/bmjopen-2018-023363. View

18.

Bridges J, Hauber A, Marshall D, Lloyd A, Prosser L, Regier D . Conjoint analysis applications in health--a checklist: a report of the ISPOR Good Research Practices for Conjoint Analysis Task Force. Value Health. 2011; 14(4):403-13. DOI: 10.1016/j.jval.2010.11.013. View

19.

Pan J, Qin X, Hsieh C . Is the pro-competition policy an effective solution for China's public hospital reform?. Health Econ Policy Law. 2016; 11(4):337-57. DOI: 10.1017/S1744133116000220. View

20.

Merle V, Germain J, Tavolacci M, Brocard C, Chefson C, Cyvoct C . Influence of infection control report cards on patients' choice of hospital: pilot survey. J Hosp Infect. 2009; 71(3):263-8. DOI: 10.1016/j.jhin.2008.11.025. View