Do patients’ preferences prevail in hospital selection?: a comparison between discrete choice experiments and revealed hospital choice
Abstract Background In patient choice, patients are expected to select the provider that best fits their preferences. In this study, we assess to what extent the hospital choice of patients in practice corresponds with their preferred choice. Methods Dutch patients with breast cancer (n = 631) and c...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-022-08403-6 |
| _version_ | 1798002946972057600 |
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| author | Benjamin H. Salampessy David Ikkersheim France R. M. Portrait Xander Koolman |
| author_facet | Benjamin H. Salampessy David Ikkersheim France R. M. Portrait Xander Koolman |
| author_sort | Benjamin H. Salampessy |
| collection | DOAJ |
| description | Abstract Background In patient choice, patients are expected to select the provider that best fits their preferences. In this study, we assess to what extent the hospital choice of patients in practice corresponds with their preferred choice. Methods Dutch patients with breast cancer (n = 631) and cataract (n = 1109) were recruited. We employed a discrete choice experiment (DCE) per condition to measure stated preferences and predict the distribution of patients across four hospitals. Each DCE included five attributes: patient experiences, a clinical outcome indicator, waiting time, travel distance and whether the hospital had been recommended (e.g., by the General Practitioner (GP)). Revealed choices were derived from claims data. Results Hospital quality was valued as most important in the DCE; the largest marginal rates of substitution (willingness to wait) were observed for the clinical outcome indicator (breast cancer: 38.6 days (95% confidence interval (95%CI): 32.9–44.2); cataract: 210.5 days (95%CI: 140.8–280.2)). In practice, it was of lesser importance. In revealed choices, travel distance became the most important attribute; it accounted for 85.5% (breast cancer) and 95.5% (cataract) of the log-likelihood. The predicted distribution of patients differed from that observed in practice in terms of absolute value and, for breast cancer, also in relative order. Similar results were observed in population weighted analyses. Discussion Study findings show that patients highly valued quality information in the choice for a hospital. However, in practice these preferences did not prevail. Our findings suggest that GPs played a major role and that patients mostly ended up selecting the nearest hospital. |
| first_indexed | 2024-04-11T12:00:23Z |
| format | Article |
| id | doaj.art-0b7ce3de0a9a4e4cb15afe15a961d451 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-11T12:00:23Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-0b7ce3de0a9a4e4cb15afe15a961d4512022-12-22T04:24:51ZengBMCBMC Health Services Research1472-69632022-09-0122111310.1186/s12913-022-08403-6Do patients’ preferences prevail in hospital selection?: a comparison between discrete choice experiments and revealed hospital choiceBenjamin H. Salampessy0David Ikkersheim1France R. M. Portrait2Xander Koolman3Department of Health Sciences, Faculty of Science, Vrije Universiteit AmsterdamKPMGDepartment of Health Sciences, Faculty of Science, Vrije Universiteit AmsterdamDepartment of Health Sciences, Faculty of Science, Vrije Universiteit AmsterdamAbstract Background In patient choice, patients are expected to select the provider that best fits their preferences. In this study, we assess to what extent the hospital choice of patients in practice corresponds with their preferred choice. Methods Dutch patients with breast cancer (n = 631) and cataract (n = 1109) were recruited. We employed a discrete choice experiment (DCE) per condition to measure stated preferences and predict the distribution of patients across four hospitals. Each DCE included five attributes: patient experiences, a clinical outcome indicator, waiting time, travel distance and whether the hospital had been recommended (e.g., by the General Practitioner (GP)). Revealed choices were derived from claims data. Results Hospital quality was valued as most important in the DCE; the largest marginal rates of substitution (willingness to wait) were observed for the clinical outcome indicator (breast cancer: 38.6 days (95% confidence interval (95%CI): 32.9–44.2); cataract: 210.5 days (95%CI: 140.8–280.2)). In practice, it was of lesser importance. In revealed choices, travel distance became the most important attribute; it accounted for 85.5% (breast cancer) and 95.5% (cataract) of the log-likelihood. The predicted distribution of patients differed from that observed in practice in terms of absolute value and, for breast cancer, also in relative order. Similar results were observed in population weighted analyses. Discussion Study findings show that patients highly valued quality information in the choice for a hospital. However, in practice these preferences did not prevail. Our findings suggest that GPs played a major role and that patients mostly ended up selecting the nearest hospital.https://doi.org/10.1186/s12913-022-08403-6Discrete choice experimentPatient preferencesChoice behaviorHospitalQuality of careRevealed and stated preferences |
| spellingShingle | Benjamin H. Salampessy David Ikkersheim France R. M. Portrait Xander Koolman Do patients’ preferences prevail in hospital selection?: a comparison between discrete choice experiments and revealed hospital choice BMC Health Services Research Discrete choice experiment Patient preferences Choice behavior Hospital Quality of care Revealed and stated preferences |
| title | Do patients’ preferences prevail in hospital selection?: a comparison between discrete choice experiments and revealed hospital choice |
| title_full | Do patients’ preferences prevail in hospital selection?: a comparison between discrete choice experiments and revealed hospital choice |
| title_fullStr | Do patients’ preferences prevail in hospital selection?: a comparison between discrete choice experiments and revealed hospital choice |
| title_full_unstemmed | Do patients’ preferences prevail in hospital selection?: a comparison between discrete choice experiments and revealed hospital choice |
| title_short | Do patients’ preferences prevail in hospital selection?: a comparison between discrete choice experiments and revealed hospital choice |
| title_sort | do patients preferences prevail in hospital selection a comparison between discrete choice experiments and revealed hospital choice |
| topic | Discrete choice experiment Patient preferences Choice behavior Hospital Quality of care Revealed and stated preferences |
| url | https://doi.org/10.1186/s12913-022-08403-6 |
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