Eliciting preferences for outpatient care experiences in Hungary: A discrete choice experiment with a national representative sample

PLoS One. 2020 Jul 31;15(7):e0235165. doi: 10.1371/journal.pone.0235165. eCollection 2020.

Abstract

Introduction: Patient-reported experience measures (PREMs) are central to inform on the responsiveness of health systems to citizens' health care needs and expectations. At their current form, PREMs do not reflect the weights that patients assign to varying aspects of the care experience. We aimed to investigate patients' preferences and willingness to pay (WTP) for attributes of the care experience in outpatient settings.

Methods: A discrete choice experiment was conducted among a representative sample of the general adult population of Hungary (n = 1000). Choice set attributes and levels were defined based on OECD's standardized PREMs (e.g. a doctor spending enough time in consultation, providing easy to understand explanations, giving opportunity to ask questions, and involving in decision making) and a price attribute. Conditional and mixed logit analyses were conducted. WTP estimates were computed in preference and WTP space.

Results: The respondents most preferred attribute was that of a doctor spending enough time in consultation, followed by involvement in decision making. Moreover, waiting times had a less important effect on respondents' choice preference compared with aspects of the doctor-patient relationship. Estimates in the WTP space varied from €4.38 (2.85-5.90) for waiting an hour less at a doctor's office to €36.13 (32.07-40.18) for a consultation where a doctor spends enough time with a patient relative to a consultation where a doctor does not.

Conclusions: A preference-based PREMs approach provide insight on the value patients assign to different aspects of their care experience. This can inform the decisions of policy-makers and other stakeholders to coordinate efforts and resource allocation in a more targeted manner, by acting on attributes of the care experience that have a greater impact on the implementation of patient-centered care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ambulatory Care / organization & administration
  • Ambulatory Care / psychology*
  • Ambulatory Care / statistics & numerical data
  • Decision Making, Shared
  • Female
  • Health Policy
  • Humans
  • Hungary
  • Male
  • Middle Aged
  • Patient Preference / statistics & numerical data*
  • Patient Reported Outcome Measures*
  • Patient-Centered Care / organization & administration
  • Physician-Patient Relations*
  • Resource Allocation / organization & administration
  • Young Adult

Grants and funding

This research was funded by the Higher Education Institutional Excellence Program of the Ministry of Human Capacities in the framework of the ‘Financial and Public Services’ research project (20764-3/2018/FEKUTSRTAT) at Corvinus University of Budapest. The research was developed within a Marie Skłodowska-Curie Innovative Training Network (HealthPros — Healthcare Performance Intelligence Professionals) that has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement Nr. 765141 (https://healthpros-h2020.eu). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.