Patientenpräferenzen bei der Ausgestaltung Integrierter Versorgungsprogramme: ein Discrete Choice Experiment

Translated title of the contribution: Patient preferences for the arrangement of integrated care programmes: A discrete choice experiment

M. Streibelt, M. Bethge

4 Citations (Scopus)

Abstract

Background: The improvement of medical treatment processes by implementing integrated care (IC) programmes should also induce positive effects for patients. To verify such effects it has to be known whether IC programmes consider patient needs better than standard care concepts. Aim: Do patients associate IC Programmes with a higher expected benefit? Method: A Discrete Choice Experiment was conducted in patients with a necessary total knee or hip replacement surgery carried out within an IC programme. Within eight scenarios (allocated on 2 decks á 4 scenarios) one out of two alternatives could be chosen, differentiated by 4 attributes: treatment consultation, type of post-operative treatment, cooperation of hospital and rehabilitation clinic and amount of additional payment. A random-effects logit model was estimated. To evaluate the monetary aspects of the attributes the willingness to pay (WTP) was identified. Results: 340 patients participated in the study. All attributes showed a significant influence on the decision. The chance of choosing a treatment was minimized by the availability of written information material compared to a consultation by a medical doctor (OR= 0.51) as well as by increased additional payment (OR= 0.97). A structured post-operative treatment (OR= 1.23) and a close cooperation (OR= 1.70) increased the chance of taking such a decision. An exposed treatment process (consultation by a medical doctor, structured post-operative treatment, close cooperation) resulted in a total WTP of 59.06 (WTP= 25.61 WTP= 8.00 WTP= 25.46 ). Conclusion: The patients expect a higher benefit by the implementation of IC programmes, if this model includes a close cooperation of hospital and rehabilitation clinic, a face-to-face consultation by the medical doctor and a structured post-operative care. The validity of the results are discussed and conclusions for research and practical fields are drawn.

Translated title of the contributionPatient preferences for the arrangement of integrated care programmes: A discrete choice experiment
Original languageGerman
JournalGesundheitsokonomie und Qualitatsmanagement
Volume14
Issue number6
Pages (from-to)288-295
Number of pages8
ISSN1432-2625
DOIs
Publication statusPublished - 2009

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