Patients’ and Relatives’ Preferences for Outpatient and Day Care Services Within End-of-Life Care in Germany – A Discrete Choice Experiment

Beate Apolinarski,1,* Lea de Jong,2,* Franziska A Herbst,1 Carolin Huperz,1,3 Hanna AA Röwer,1 Nils Schneider,1 Kathrin Damm,2,* Stephanie Stiel1,* 1Institute for General Practice and Palliative Care, Hannover Medical School, Hannover, Germany; 2Center for Health Econ...

Full description

Bibliographic Details
Main Authors: Apolinarski B, de Jong L, Herbst FA, Huperz C, Röwer HAA, Schneider N, Damm K, Stiel S
Format: Article
Language:English
Published: Dove Medical Press 2024-02-01
Series:Patient Preference and Adherence
Subjects:
Online Access:https://www.dovepress.com/patients-and-relatives-preferences-for-outpatient-and-day-care-service-peer-reviewed-fulltext-article-PPA
_version_ 1797279425172078592
author Apolinarski B
de Jong L
Herbst FA
Huperz C
Röwer HAA
Schneider N
Damm K
Stiel S
author_facet Apolinarski B
de Jong L
Herbst FA
Huperz C
Röwer HAA
Schneider N
Damm K
Stiel S
author_sort Apolinarski B
collection DOAJ
description Beate Apolinarski,1,* Lea de Jong,2,* Franziska A Herbst,1 Carolin Huperz,1,3 Hanna AA Röwer,1 Nils Schneider,1 Kathrin Damm,2,* Stephanie Stiel1,* 1Institute for General Practice and Palliative Care, Hannover Medical School, Hannover, Germany; 2Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany; 3Faculty of Engineering and Mathematics, Bielefeld University of Applied Sciences, Bielefeld, Germany*These authors contributed equally to this workCorrespondence: Franziska A Herbst, Hannover Medical School, Institute for General Practice and Palliative Care, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany, Fax +49 511 532 4176, Email herbst.franziska@mh-hannover.dePurpose: In Germany, patients with incurable chronic diseases living at home increasingly have the option of using outpatient and day care hospice and specialized palliative care services. The present study examined and compared patients’ and their relatives’ preferences for end-of-life outpatient and day care services.Patients and Methods: The study used a questionnaire integrating a discrete choice experiment. For six scenarios, participants chose between two hypothetical end-of-life care offers, described by seven attributes. The model compared place of care, frequency and duration of care and support, specialized medical palliative care, accompanied activities, and relieving patient counselling. The model also included optional overnight care and willingness to pay. Patients and the relatives of patients suffering from incurable, chronic diseases who were not yet receiving palliative care were recruited via hospitals and self-help groups (06/2021– 07/2022).Results: The results were based on data from 436 questionnaires (patients: n=263, relatives: n=173). All attributes had a statistically significant impact on choice decisions, with place of care showing the greatest importance. All respondents highly preferred care in the patient’s home over out-of-home care. Patients stressed the importance of special medical (palliative) care and valued accompanied activities, often facilitated by hospice volunteers. Relatives, but not patients, considered the frequency and duration of care highly relevant.Conclusion: The results suggest a higher demand for care in the patient’s home than for out-of-home care. Patients’ and relatives’ high preference for special medical care and the relief of family caregiver burden should be considered in the design of day care services.Keywords: palliative care, hospice care, preferences, discrete choice experiment, medical day care, ambulatory care
first_indexed 2024-03-07T16:25:08Z
format Article
id doaj.art-e087dfdfe8c64e50aa8037175584a09a
institution Directory Open Access Journal
issn 1177-889X
language English
last_indexed 2024-03-07T16:25:08Z
publishDate 2024-02-01
publisher Dove Medical Press
record_format Article
series Patient Preference and Adherence
spelling doaj.art-e087dfdfe8c64e50aa8037175584a09a2024-03-03T18:36:48ZengDove Medical PressPatient Preference and Adherence1177-889X2024-02-01Volume 1851952990808Patients’ and Relatives’ Preferences for Outpatient and Day Care Services Within End-of-Life Care in Germany – A Discrete Choice ExperimentApolinarski Bde Jong LHerbst FAHuperz CRöwer HAASchneider NDamm KStiel SBeate Apolinarski,1,* Lea de Jong,2,* Franziska A Herbst,1 Carolin Huperz,1,3 Hanna AA Röwer,1 Nils Schneider,1 Kathrin Damm,2,* Stephanie Stiel1,* 1Institute for General Practice and Palliative Care, Hannover Medical School, Hannover, Germany; 2Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany; 3Faculty of Engineering and Mathematics, Bielefeld University of Applied Sciences, Bielefeld, Germany*These authors contributed equally to this workCorrespondence: Franziska A Herbst, Hannover Medical School, Institute for General Practice and Palliative Care, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany, Fax +49 511 532 4176, Email herbst.franziska@mh-hannover.dePurpose: In Germany, patients with incurable chronic diseases living at home increasingly have the option of using outpatient and day care hospice and specialized palliative care services. The present study examined and compared patients’ and their relatives’ preferences for end-of-life outpatient and day care services.Patients and Methods: The study used a questionnaire integrating a discrete choice experiment. For six scenarios, participants chose between two hypothetical end-of-life care offers, described by seven attributes. The model compared place of care, frequency and duration of care and support, specialized medical palliative care, accompanied activities, and relieving patient counselling. The model also included optional overnight care and willingness to pay. Patients and the relatives of patients suffering from incurable, chronic diseases who were not yet receiving palliative care were recruited via hospitals and self-help groups (06/2021– 07/2022).Results: The results were based on data from 436 questionnaires (patients: n=263, relatives: n=173). All attributes had a statistically significant impact on choice decisions, with place of care showing the greatest importance. All respondents highly preferred care in the patient’s home over out-of-home care. Patients stressed the importance of special medical (palliative) care and valued accompanied activities, often facilitated by hospice volunteers. Relatives, but not patients, considered the frequency and duration of care highly relevant.Conclusion: The results suggest a higher demand for care in the patient’s home than for out-of-home care. Patients’ and relatives’ high preference for special medical care and the relief of family caregiver burden should be considered in the design of day care services.Keywords: palliative care, hospice care, preferences, discrete choice experiment, medical day care, ambulatory carehttps://www.dovepress.com/patients-and-relatives-preferences-for-outpatient-and-day-care-service-peer-reviewed-fulltext-article-PPApalliative carehospice carepreferencesdiscrete choice experimentmedical day careambulatory care
spellingShingle Apolinarski B
de Jong L
Herbst FA
Huperz C
Röwer HAA
Schneider N
Damm K
Stiel S
Patients’ and Relatives’ Preferences for Outpatient and Day Care Services Within End-of-Life Care in Germany – A Discrete Choice Experiment
Patient Preference and Adherence
palliative care
hospice care
preferences
discrete choice experiment
medical day care
ambulatory care
title Patients’ and Relatives’ Preferences for Outpatient and Day Care Services Within End-of-Life Care in Germany – A Discrete Choice Experiment
title_full Patients’ and Relatives’ Preferences for Outpatient and Day Care Services Within End-of-Life Care in Germany – A Discrete Choice Experiment
title_fullStr Patients’ and Relatives’ Preferences for Outpatient and Day Care Services Within End-of-Life Care in Germany – A Discrete Choice Experiment
title_full_unstemmed Patients’ and Relatives’ Preferences for Outpatient and Day Care Services Within End-of-Life Care in Germany – A Discrete Choice Experiment
title_short Patients’ and Relatives’ Preferences for Outpatient and Day Care Services Within End-of-Life Care in Germany – A Discrete Choice Experiment
title_sort patients rsquo and relatives rsquo preferences for outpatient and day care services within end of life care in germany ndash a discrete choice experiment
topic palliative care
hospice care
preferences
discrete choice experiment
medical day care
ambulatory care
url https://www.dovepress.com/patients-and-relatives-preferences-for-outpatient-and-day-care-service-peer-reviewed-fulltext-article-PPA
work_keys_str_mv AT apolinarskib patientsrsquoandrelativesrsquopreferencesforoutpatientanddaycareserviceswithinendoflifecareingermanyndashadiscretechoiceexperiment
AT dejongl patientsrsquoandrelativesrsquopreferencesforoutpatientanddaycareserviceswithinendoflifecareingermanyndashadiscretechoiceexperiment
AT herbstfa patientsrsquoandrelativesrsquopreferencesforoutpatientanddaycareserviceswithinendoflifecareingermanyndashadiscretechoiceexperiment
AT huperzc patientsrsquoandrelativesrsquopreferencesforoutpatientanddaycareserviceswithinendoflifecareingermanyndashadiscretechoiceexperiment
AT rowerhaa patientsrsquoandrelativesrsquopreferencesforoutpatientanddaycareserviceswithinendoflifecareingermanyndashadiscretechoiceexperiment
AT schneidern patientsrsquoandrelativesrsquopreferencesforoutpatientanddaycareserviceswithinendoflifecareingermanyndashadiscretechoiceexperiment
AT dammk patientsrsquoandrelativesrsquopreferencesforoutpatientanddaycareserviceswithinendoflifecareingermanyndashadiscretechoiceexperiment
AT stiels patientsrsquoandrelativesrsquopreferencesforoutpatientanddaycareserviceswithinendoflifecareingermanyndashadiscretechoiceexperiment