Analysis of medical preference of rural day surgery patients: a discrete choice experiment_West China Medical Journal

Authors：

LU Yun ¹ , ZHENG Guangyan ² , TU Shiping ² ,  LI Yueping ^3,4

1. School of Public Health, Fujian Medical University, Fuzhou, Fujian 350122, P. R. China;
2. Hospital Service Management Department, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P. R. China;
3. Library of Fujian Medical University, Fuzhou, Fujian 350122, P. R. China;
4. School of Health Management, Fujian Medical University, Fuzhou, Fujian 350122, P. R. China;

Corresponding author：

LI Yueping, Email: fmulyp@163.com

Keywords：

Rural area; day surgery; medical preference for medical treatment; discrete choice experiment; county-level hospital

DOI：

10.7507/1002-0179.202307115

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To quantify the potential medical preference of rural day surgery patients, and provide a policy basis for further promoting the development of day surgery in county-level hospitals. Methods Based on the discrete choice experimental design questionnaire, all rural inpatients undergoing day surgery in three departments of the First Affiliated Hospital of Fujian Medical University between September and October 2022 were selected as survey subjects, and one-to-one structured questionnaire interviews were conducted. The Mixed Logit model was used to analyze the preference size, marginal willingness to pay and average marginal effect of patients on five medical attributes and levels. Results A total of 223 copies of questionnaire were issued, and 223 valid ones were collected, with an effective recovery rate of 100%. The five medical attributes were statistically significant in the impact on the medical preference of rural day surgery patients (P<0.001), and the patient’s preference was most affected by the physician category attribute (β=1.776, P<0.001). When the medical services from experts were unavailable, patients hoped to get 4862.51 yuan in compensation; when the patients received medical services from county-level hospitals instead of higher level hospitals, patients hoped to get 3154.60 yuan in compensation; when the availability of medical equipment and drugs was low, patients hoped to get 1447.72 yuan in compensation; patients were willing to spend 1197.29 yuan more to reduce the time spent from home to hospital. When the completeness of hospital medical equipment changed from “low” to “high”, patients’ preference increased by 52.89%. Conclusion Focusing on the cultivation of health personnel and the availability of medical equipment and drugs in county-level hospitals has a positive effect on improving the development of day surgery in county-level hospitals.

Citation： LU Yun, ZHENG Guangyan, TU Shiping, LI Yueping. Analysis of medical preference of rural day surgery patients: a discrete choice experiment. West China Medical Journal, 2023, 38(12): 1857-1862. doi: 10.7507/1002-0179.202307115 Copy

1.	中国日间学术合作联盟, 国家卫生健康委卫生发展研究中心. 中国日间手术发展报告 2020. 北京: 北京大学医学出版社, 2020: 5.
2.	姚常房. 日间手术未来的路更宽了. 健康报, 2022-03-04(4).
3.	马瑞萍, 高楠, 金芳, 等. 日间手术绩效管理导向模式实践. 中国医院, 2022, 26(5): 91-93.
4.	彭莹莹, 熊巨洋, 黎相麟, 等. 基于离散选择实验的城市老年慢性病患者医疗服务利用偏好研究. 中国卫生政策研究, 2019, 12(9): 54-59.
5.	王翌秋, 张兵. 农村居民就诊单位选择影响因素的实证分析. 中国农村经济, 2009(2): 77-85.
6.	刘儒月, 李一帆, 魏文剑, 等. 山东省农村居民潜在癌症就医偏好分析——一项离散选择实验. 中国肿瘤, 2022, 31(10): 794-802.
7.	Johnson R, Orme B. Getting the most from CBC. Sawtooth Software research paper series. Sequim, WA: Sawtooth Software, 2003: 6-7.
8.	Orme B. Sample size issues for conjoint analysis studies. Sawtooth Software technical paper. Sequim, WA: Sawtooth Software, 1998: 6-9.
9.	连东晴, 李跃平, 卢若艳. 基于离散选择试验的贫困地区乡镇卫生院护理人员工作偏好研究. 中国全科医学, 2020, 23(11): 1421-1424.
10.	Hole AR. Mixed logit modeling in Stata - An overview//2013 UK Stata Users Group meeting. London: Stata Users Group, 2013.
11.	刘晓云, 窦丽霞. 离散选择模型在卫生人力政策研究中的应用. 中国卫生政策研究, 2011, 4(8): 24-28.
12.	Hanson K, Jack W. Health worker preferences for job attributes in Ethiopia: results from a discrete choice experiment. Washington, D.C.: Georgetown University, 2008.
13.	Berhane A, Enquselassie F. Patients’ preferences for attributes related to health care services at hospitals in Amhara Region, northern Ethiopia: a discrete choice experiment. Patient Prefer Adherence, 2015, 9: 1293-1301.
14.	O’Hara NN, Slobogean GP, Mohammadi T, et al. Are patients willing to pay for total shoulder arthroplasty? Evidence from a discrete choice experiment. Can J Surg, 2016, 59(2): 107-112.
15.	Liu Y, Zhong L, Yuan S, et al. Why patients prefer high-level healthcare facilities: a qualitative study using focus groups in rural and urban China. BMJ Glob Health, 2018, 3(5): e000854.
16.	陈楚君, 陈卫銮, 黄少娟. 影响食管癌患者早日就医的质性研究. 现代临床护理, 2015(4): 38-42.
17.	Lendado TA, Bitew S, Elias F, et al. 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.
18.	Liu Y, Kong Q, Wang S, et al. The impact of hospital attributes on patient choice for first visit: evidence from a discrete choice experiment in Shanghai, China. Health Policy Plan, 2020, 35(3): 267-278.
19.	Hanson K, McPake B, Nakamba P, et al. Preferences for hospital quality in Zambia: results from a discrete choice experiment. Health Econ, 2005, 14(7): 687-701.
20.	于丽华. 中国日间手术发展的历程与展望. 中国医院管理, 2016, 36(6): 16-18.
21.	翟东升. 基层医院无张力疝修补日间手术的应用体会. 中华疝和腹壁外科杂志(电子版), 2011, 5(4): 480-482.
22.	Oredola AS, Odusanya OO. A survey of the perception of the quality of and preference of healthcare services amongst residents of Abeokuta South Local Government, Ogun State, Nigeria. Niger J Clin Pract, 2017, 20(9): 1088-1097.
23.	卢政扬. 日间手术选择及其影响因素分析. 济南: 山东大学, 2018.
24.	Cutler H, Gu Y, Olin E. Assessing choice for public hospital patients. Sydney: Macquarie University, 2017.

1. 中国日间学术合作联盟, 国家卫生健康委卫生发展研究中心. 中国日间手术发展报告 2020. 北京: 北京大学医学出版社, 2020: 5.
2. 姚常房. 日间手术未来的路更宽了. 健康报, 2022-03-04(4).
3. 马瑞萍, 高楠, 金芳, 等. 日间手术绩效管理导向模式实践. 中国医院, 2022, 26(5): 91-93.
4. 彭莹莹, 熊巨洋, 黎相麟, 等. 基于离散选择实验的城市老年慢性病患者医疗服务利用偏好研究. 中国卫生政策研究, 2019, 12(9): 54-59.
5. 王翌秋, 张兵. 农村居民就诊单位选择影响因素的实证分析. 中国农村经济, 2009(2): 77-85.
6. 刘儒月, 李一帆, 魏文剑, 等. 山东省农村居民潜在癌症就医偏好分析——一项离散选择实验. 中国肿瘤, 2022, 31(10): 794-802.
7. Johnson R, Orme B. Getting the most from CBC. Sawtooth Software research paper series. Sequim, WA: Sawtooth Software, 2003: 6-7.
8. Orme B. Sample size issues for conjoint analysis studies. Sawtooth Software technical paper. Sequim, WA: Sawtooth Software, 1998: 6-9.
9. 连东晴, 李跃平, 卢若艳. 基于离散选择试验的贫困地区乡镇卫生院护理人员工作偏好研究. 中国全科医学, 2020, 23(11): 1421-1424.
10. Hole AR. Mixed logit modeling in Stata - An overview//2013 UK Stata Users Group meeting. London: Stata Users Group, 2013.
11. 刘晓云, 窦丽霞. 离散选择模型在卫生人力政策研究中的应用. 中国卫生政策研究, 2011, 4(8): 24-28.
12. Hanson K, Jack W. Health worker preferences for job attributes in Ethiopia: results from a discrete choice experiment. Washington, D.C.: Georgetown University, 2008.
13. Berhane A, Enquselassie F. Patients’ preferences for attributes related to health care services at hospitals in Amhara Region, northern Ethiopia: a discrete choice experiment. Patient Prefer Adherence, 2015, 9: 1293-1301.
14. O’Hara NN, Slobogean GP, Mohammadi T, et al. Are patients willing to pay for total shoulder arthroplasty? Evidence from a discrete choice experiment. Can J Surg, 2016, 59(2): 107-112.
15. Liu Y, Zhong L, Yuan S, et al. Why patients prefer high-level healthcare facilities: a qualitative study using focus groups in rural and urban China. BMJ Glob Health, 2018, 3(5): e000854.
16. 陈楚君, 陈卫銮, 黄少娟. 影响食管癌患者早日就医的质性研究. 现代临床护理, 2015(4): 38-42.
17. Lendado TA, Bitew S, Elias F, et al. 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.
18. Liu Y, Kong Q, Wang S, et al. The impact of hospital attributes on patient choice for first visit: evidence from a discrete choice experiment in Shanghai, China. Health Policy Plan, 2020, 35(3): 267-278.
19. Hanson K, McPake B, Nakamba P, et al. Preferences for hospital quality in Zambia: results from a discrete choice experiment. Health Econ, 2005, 14(7): 687-701.
20. 于丽华. 中国日间手术发展的历程与展望. 中国医院管理, 2016, 36(6): 16-18.
21. 翟东升. 基层医院无张力疝修补日间手术的应用体会. 中华疝和腹壁外科杂志(电子版), 2011, 5(4): 480-482.
22. Oredola AS, Odusanya OO. A survey of the perception of the quality of and preference of healthcare services amongst residents of Abeokuta South Local Government, Ogun State, Nigeria. Niger J Clin Pract, 2017, 20(9): 1088-1097.
23. 卢政扬. 日间手术选择及其影响因素分析. 济南: 山东大学, 2018.
24. Cutler H, Gu Y, Olin E. Assessing choice for public hospital patients. Sydney: Macquarie University, 2017.

Previous Article
Bibliometric analysis on hospital operations management via CiteSpace
Next Article
Safety and feasibility of gluteal muscle contracture in day surgery mode

West China Medical Journal

Analysis of medical preference of rural day surgery patients: a discrete choice experiment

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content