家长对非计划性儿科医疗保健的偏好：离散选择实验。

Parent's preferences for unscheduled paediatric healthcare: A discrete choice experiment.

机构信息

School of Psychology, Dublin City University, Dublin 9, Ireland.

UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), UCD School of Nursing, Midwifery and Health Systems, UCD College of Health and Agricultural Sciences, Dublin, Ireland.

出版信息

Health Expect. 2023 Oct;26(5):1931-1940. doi: 10.1111/hex.13802. Epub 2023 Jun 20.

DOI:10.1111/hex.13802

PMID:37338038

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10485340/

Abstract

BACKGROUND

Unscheduled healthcare is a key component of healthcare delivery and makes up a significant proportion of healthcare access, with children being particularly high users of unscheduled healthcare. Understanding the relative importance of factors that influence this behaviour and decision-making is fundamental to ensuring the system is best designed to meet the needs of users and foster appropriate cost-effective usage of health system resources.

OBJECTIVE

The aim of the study was to identify the parent's preferences for unscheduled healthcare for a common mild childhood illness.

DESIGN

A discrete choice experiment (DCE) was developed to identify the preferences of parents accessing unscheduled healthcare for their children.

SETTING AND PARTICIPANTS

Data were collected from parents in Ireland (N = 458) to elicit preferences across five attributes: timeliness, appointment type, healthcare professional attended, telephone guidance before attending and cost.

RESULTS

Using a random parameters logit model, all attributes were statistically significant, cost (β = -5.064, 95% confidence interval, CI [-5.60, -4.53]), same-day (β = 1.386, 95% CI [1.19, 1.58]) or next-day access (β = 0.857, 95% CI [0.73, 0.98]), coupled with care by their own general practitioner (β = 0.748, 95% CI [0.61, 0.89]), identified as the strongest preferences of parents accessing unscheduled healthcare for their children.

DISCUSSION

The results have implications for policy development and implementation initiatives that seek to improve unscheduled health services as understanding how parents use these services can maximise their effectiveness.

PATIENT OR PUBLIC CONTRIBUTION

The development of the DCE included a qualitative research component to ensure that the content accurately reflected parents experiences when seeking healthcare. Before data collection, a pilot test was carried out with the target population to gather their views on the survey.

摘要

背景

非计划性医疗是医疗服务的一个关键组成部分，构成了医疗可及性的重要组成部分，儿童是非计划性医疗的主要使用者。了解影响这种行为和决策的因素的相对重要性对于确保系统能够最好地满足用户的需求并促进对卫生系统资源的适当具有成本效益的使用至关重要。

目的

本研究旨在确定父母对常见轻度儿童疾病的非计划性医疗的偏好。

设计

开发了一项离散选择实验 (DCE)，以确定寻求非计划性儿童医疗服务的父母的偏好。

地点和参与者

从爱尔兰的父母那里收集数据（N=458），以在五个属性上得出偏好：及时性、预约类型、就诊的医疗保健专业人员、就诊前的电话指导和费用。

结果

使用随机参数对数模型，所有属性均具有统计学意义，成本（β=-5.064，95%置信区间，CI[-5.60，-4.53]）、当天（β=1.386，95%CI[1.19，1.58]）或次日（β=0.857，95%CI[0.73，0.98]）获得访问权限，再加上由他们自己的全科医生提供的护理（β=0.748，95%CI[0.61，0.89]），被确定为父母寻求非计划性儿童医疗服务的最强烈偏好。