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.	中國日間學術合作聯盟, 國家衛生健康委衛生發展研究中心. 中國日間手術發展報告 2020. 北京: 北京大學醫學出版社, 2020: 5.
2.	姚常房. 日間手術未來的路更寬了. 健康報, 2022-03-04(4).
3.	馬瑞萍, 高楠, 金芳, 等. 日間手術績效管理導向模式實踐. 中國醫院, 2022, 26(5): 91-93.
4.	彭瑩瑩, 熊巨洋, 黎相麟, 等. 基于離散選擇實驗的城市老年慢性病患者醫療服務利用偏好研究. 中國衛生政策研究, 2019, 12(9): 54-59.
5.	王翌秋, 張兵. 農村居民就診單位選擇影響因素的實證分析. 中國農村經濟, 2009(2): 77-85.
6.	劉儒月, 李一帆, 魏文劍, 等. 山東省農村居民潛在癌癥就醫偏好分析——一項離散選擇實驗. 中國腫瘤, 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.	連東晴, 李躍平, 盧若艷. 基于離散選擇試驗的貧困地區鄉鎮衛生院護理人員工作偏好研究. 中國全科醫學, 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.	劉曉云, 竇麗霞. 離散選擇模型在衛生人力政策研究中的應用. 中國衛生政策研究, 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.	陳楚君, 陳衛鑾, 黃少娟. 影響食管癌患者早日就醫的質性研究. 現代臨床護理, 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.	于麗華. 中國日間手術發展的歷程與展望. 中國醫院管理, 2016, 36(6): 16-18.
21.	翟東升. 基層醫院無張力疝修補日間手術的應用體會. 中華疝和腹壁外科雜志(電子版), 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.	盧政揚. 日間手術選擇及其影響因素分析. 濟南: 山東大學, 2018.
24.	Cutler H, Gu Y, Olin E. Assessing choice for public hospital patients. Sydney: Macquarie University, 2017.

1. 中國日間學術合作聯盟, 國家衛生健康委衛生發展研究中心. 中國日間手術發展報告 2020. 北京: 北京大學醫學出版社, 2020: 5.
2. 姚常房. 日間手術未來的路更寬了. 健康報, 2022-03-04(4).
3. 馬瑞萍, 高楠, 金芳, 等. 日間手術績效管理導向模式實踐. 中國醫院, 2022, 26(5): 91-93.
4. 彭瑩瑩, 熊巨洋, 黎相麟, 等. 基于離散選擇實驗的城市老年慢性病患者醫療服務利用偏好研究. 中國衛生政策研究, 2019, 12(9): 54-59.
5. 王翌秋, 張兵. 農村居民就診單位選擇影響因素的實證分析. 中國農村經濟, 2009(2): 77-85.
6. 劉儒月, 李一帆, 魏文劍, 等. 山東省農村居民潛在癌癥就醫偏好分析——一項離散選擇實驗. 中國腫瘤, 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. 連東晴, 李躍平, 盧若艷. 基于離散選擇試驗的貧困地區鄉鎮衛生院護理人員工作偏好研究. 中國全科醫學, 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. 劉曉云, 竇麗霞. 離散選擇模型在衛生人力政策研究中的應用. 中國衛生政策研究, 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. 陳楚君, 陳衛鑾, 黃少娟. 影響食管癌患者早日就醫的質性研究. 現代臨床護理, 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. 于麗華. 中國日間手術發展的歷程與展望. 中國醫院管理, 2016, 36(6): 16-18.
21. 翟東升. 基層醫院無張力疝修補日間手術的應用體會. 中華疝和腹壁外科雜志(電子版), 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. 盧政揚. 日間手術選擇及其影響因素分析. 濟南: 山東大學, 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