scholarly journals The impact of non-health attributes of care on patients' choice of GP

2005 ◽  
Vol 11 (1) ◽  
pp. 40 ◽  
Author(s):  
Marion Haas
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Discrete Choice ◽  
Choice Experiment ◽  
The Past ◽  
Health Factors ◽  
General Practice Consultation ◽  
Minor Condition ◽  
A Minor ◽  
The Impact

After completing a structured evaluation of their general practitioner (GP) in terms of non-health factors, 128 people who had visited their GP in the past six months for treatment of a minor condition were administered a discrete choice experiment (DCE) designed to evaluate their preferences for non-health attributes of care within a general practice consultation. SAS and SYSTAT were used to analyse responses. Trust, legitimation, recognition of and support for emotional distress, dignity, reassurance and information (whether it is asked for or not), were the attributes respondents valued most highly. In general, participants were unwilling to change GPs.

scholarly journals Standing order use in general practice: the views of medicine, nursing and pharmacy stakeholder organisations

2017 ◽  
Vol 9 (1) ◽  
pp. 47 ◽  
Author(s):  
Robyn Taylor ◽  
Eileen McKinlay ◽  
Caroline Morris
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Access To Health Care ◽  
Timely Manner ◽  
Face To Face ◽  
Standing Order ◽  
Access To Health ◽  
General Practices ◽  
Pharmacy Data ◽  
The Impact

ABSTRACT INTRODUCTION Standing orders are used by many general practices in New Zealand. They allow a practice nurse to assess patients and administer and/or supply medicines without needing intervention from a general practitioner. AIM To explore organisational strategic stakeholders’ views of standing order use in general practice nationally. METHODS Eight semi-structured, qualitative, face-to-face interviews were conducted with participants representing key primary care stakeholder organisations from nursing, medicine and pharmacy. Data were analysed using a qualitative inductive thematic approach. RESULTS Three key themes emerged: a lack of understanding around standing order use in general practice, legal and professional concerns, and the impact on workforce and clinical practice. Standing orders were perceived to extend nursing practice and seen as a useful tool in enabling patients to access medicines in a safe and timely manner. DISCUSSION The variability in understanding of the definition and use of standing orders appears to relate to a lack of leadership in this area. Leadership should facilitate the required development of standardised resources and quality assurance measures to aid implementation. If these aspects are addressed, then standing orders will continue to be a useful tool in general practice and enable patients to have access to health care and, if necessary, to medicines without seeing a general practitioner.

Patient preferences for specialist outpatient video consultations: A discrete choice experiment

2021 ◽  
pp. 1357633X2110228
Author(s):  
Centaine L Snoswell ◽  
Anthony C Smith ◽  
Matthew Page ◽  
Liam J Caffery
Keyword(s):  
General Practitioner ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Healthcare Delivery ◽  
General Practitioner Practice ◽  
Specialist Care ◽  
Time Away ◽  
Out Of Pocket Costs

Introduction Telehealth has been shown to improve access to care, reduce personal expenses and reduce the need for travel. Despite these benefits, patients may be less inclined to seek a telehealth service, if they consider it inferior to an in-person encounter. The aims of this study were to identify patient preferences for attributes of a healthcare service and to quantify the value of these attributes. Methods We surveyed patients who had taken an outpatient telehealth consult in the previous year using a survey that included a discrete choice experiment. We investigated patient preferences for attributes of healthcare delivery and their willingness to pay for out-of-pocket costs. Results Patients ( n = 62) preferred to have a consultation, regardless of type, than no consultation at all. Patients preferred healthcare services with lower out-of-pocket costs, higher levels of perceived benefit and less time away from usual activities ( p < 0.008). Most patients preferred specialist care over in-person general practitioner care. Their order of preference to obtain specialist care was a videoconsultation into the patient’s local general practitioner practice or hospital ( p < 0.003), a videoconsultation into the home, and finally travelling for in-person appointment. Patients were willing to pay out-of-pocket costs for attributes they valued: to be seen by a specialist over videoconference ($129) and to reduce time away from usual activities ($160). Conclusion Patients value specialist care, lower out-of-pocket costs and less time away from usual activities. Telehealth is more likely than in-person care to cater to these preferences in many instances.

scholarly journals Discrete choice experiment for eliciting preference for health services for patients with ALS and their informal caregivers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katy Tobin ◽  
Sinead Maguire ◽  
Bernie Corr ◽  
Charles Normand ◽  
Orla Hardiman ◽  
...  
Keyword(s):  
Health Services ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Strong Preference ◽  
Multidisciplinary Teams ◽  
Relative Importance ◽  
Trade Offs ◽  
Als Patients ◽  
The Impact

Abstract Background Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative condition with a mean life expectancy of 3 years from first symptom. Understanding the factors that are important to both patients and their caregivers has the potential to enhance service delivery and engagement, and improve efficiency. The Discrete Choice Experiment (DCE) is a stated preferences method which asks service users to make trade-offs for various attributes of health services. This method is used to quantify preferences and shows the relative importance of the attributes in the experiment, to the service user. Methods A DCE with nine choice sets was developed to measure the preferences for health services of ALS patients and their caregivers and the relative importance of various aspects of care, such as timing of care, availability of services, and decision making. The DCE was presented to patients with ALS, and their caregivers, recruited from a national multidisciplinary clinic. A random effects probit model was applied to estimate the impact of each attribute on a participant’s choice. Results Patients demonstrated the strongest preferences about timing of receiving information about ALS. A strong preference was also placed on seeing the hospice care team later rather than early on in the illness. Patients also indicated their willingness to consider the use of communication devices. Grouping by stage of disease, patients who were in earlier stages of disease showed a strong preference for receipt of extensive information about ALS at the time of diagnosis. Caregivers showed a strong preference for engagement with healthcare professionals, an attribute that was not prioritised by patients. Conclusions The DCE method can be useful in uncovering priorities of patients and caregivers with ALS. Patients and caregivers have different priorities relating to health services and the provision of care in ALS, and patient preferences differ based on the stage and duration of their illness. Multidisciplinary teams must calibrate the delivery of care in the context of the differing expectations, needs and priorities of the patient/caregiver dyad.

scholarly journals Patient preferences for use of virtual consultations in an orthopaedic rehabilitation setting: Results from a discrete choice experiment

2021 ◽  
pp. 135581962110354
Author(s):  
Anthony W Gilbert ◽  
Emmanouil Mentzakis ◽  
Carl R May ◽  
Maria Stokes ◽  
Jeremy Jones
Keyword(s):  
Conceptual Model ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Best Practice ◽  
Time Of Day ◽  
Problem Area ◽  
Fractional Factorial ◽  
The Impact

Objective Virtual Consultations may reduce the need for face-to-face outpatient appointments, thereby potentially reducing the cost and time involved in delivering health care. This study reports a discrete choice experiment (DCE) that identifies factors that influence patient preferences for virtual consultations in an orthopaedic rehabilitation setting. Methods Previous research from the CONNECT (Care in Orthopaedics, burdeN of treatmeNt and the Effect of Communication Technology) Project and best practice guidance informed the development of our DCE. An efficient fractional factorial design with 16 choice scenarios was created that identified all main effects and partial two-way interactions. The design was divided into two blocks of eight scenarios each, to reduce the impact of cognitive fatigue. Data analysis were conducted using binary logit regression models. Results Sixty-one paired response sets (122 subjects) were available for analysis. DCE factors (whether the therapist is known to the patient, duration of appointment, time of day) and demographic factors (patient qualifications, access to equipment, difficulty with activities, multiple health issues, travel costs) were significant predictors of preference. We estimate that a patient is less than 1% likely to prefer a virtual consultation if the patient has a degree, is without access to the equipment and software to undertake a virtual consultation, does not have difficulties with day-to-day activities, is undergoing rehabilitation for one problem area, has to pay less than £5 to travel, is having a consultation with a therapist not known to them, in 1 weeks’ time, lasting 60 minutes, at 2 pm. We have developed a simple conceptual model to explain how these factors interact to inform preference, including patients’ access to resources, context for the consultation and the requirements of the consultation. Conclusions This conceptual model provides the framework to focus attention towards factors that might influence patient preference for virtual consultations. Our model can inform the development of future technologies, trials, and qualitative work to further explore the mechanisms that influence preference.

scholarly journals Assessing cigarette packaging and labelling policy effects on early adolescents: results from a discrete choice experiment

2020 ◽  
pp. tobaccocontrol-2019-055463
Author(s):  
Inti Barrientos-Gutierrez ◽  
Farahnaz Islam ◽  
Yoo Jin Cho ◽  
Ramzi George Salloum ◽  
Jordan Louviere ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Early Adolescents ◽  
Interactive Effects ◽  
Brand Name ◽  
Warning Label ◽  
Plain Packaging ◽  
Tobacco Marketing ◽  
The Impact

IntroductionCigarette packaging is a primary channel for tobacco advertising, particularly in countries where traditional channels are restricted. The current study evaluated the independent and interactive effects of cigarette packaging and health warning label (HWL) characteristics on perceived appeal of cigarette brands for early adolescents in Mexico.MethodsA discrete choice experiment (DCE) was conducted with early adolescents, aged 12–14 years (n=4251). The DCE involved a 3×25 design with six attributes: brand (Marlboro, Pall Mall, Camel), tobacco flavour (regular, menthol), flavour capsule (none, 1 or 2 capsules), presence of descriptive terms, branding (vs plain packaging), HWL size (30%, 75%) and HWL content (emphysema vs mouth cancer). Participants viewed eight sets of three cigarette packs and selected a pack in each set that: (1) is most/least attractive, (2) they are most/least interested in trying or (3) is most/least harmful, with a no difference option.ResultsParticipants perceived packs as less attractive, less interesting to try and more harmful if they had plain packaging or had larger HWLs, with the effect being most pronounced when plain packaging is combined with larger HWLs. For attractiveness, plain packaging had the biggest influence on choice (43%), followed by HWL size (19%). Interest in trying was most influenced by brand name (34%), followed by plain packaging (29%). Perceived harm was most influenced by brand name (30%), followed by HWL size (29%).ConclusionIncreasing the size of HWLs and implementing plain packaging appear to reduce the appeal of cigarettes to early adolescents. Countries should adopt these policies to minimise the impact of tobacco marketing.

scholarly journals Factors influencing the imposition of a charge on the entrance to the interpretive trails in the large protected areas

2013 ◽  
Vol 61 (4) ◽  
pp. 1041-1049
Author(s):  
Josef Navrátil ◽  
Kamil Pícha
Keyword(s):  
Discrete Choice ◽  
Choice Experiment ◽  
Fractional Factorial Design ◽  
Multinomial Logit Model ◽  
Fractional Factorial ◽  
Large Protected Areas ◽  
A Charge ◽  
Main Effects ◽  
The Impact ◽  
The Way

The aim of this paper is to assess the relation between the character of the interpretive trail and the imposition of a charge on the entrance. This was done using the discrete choice experiment that involves eight attributes, seven of which are with three levels: the overall character of the trail, the way that the route signs are used in the terrain, the ways of providing information, the length of the trail, the way of the routing, the focus of the trail, and the price of the entrance. There is also one with two levels that involves the existence of the places for rest. The fractional factorial design was used (the orthogonal main effects plan) and the Multinomial Logit Model was used in analyzing the data. The 2,830 choices were done by random sampled visitors from eight tourist locations in the Tourist Regions of the Šumava Mts. and South Bohemia during the summer season 2012. The impact of the character of the trail was especially detected in the model. Except for that, the equipment of the trail and its length have had the fundamental impact on the choice of the trail as well. Those longer and worse equipped trails have a significantly lower degree of utility for the respondents. What is quite surprising is that the respondents refused the ecotourism elements of the interpretive trails, such as the possibility of going through the trail on horseback or the accompaniment of an expert who would provide some comments, as it is common to do this at historical attractions within those sightseeing paths.

scholarly journals Patient preferences for preventive health checks in Danish general practice: a discrete choice experiment among patients at high risk of noncommunicable diseases

2020 ◽  
Vol 37 (5) ◽  
pp. 689-694
Author(s):  
Lars Bruun Larsen ◽  
Trine Thilsing ◽  
Line Bjørnskov Pedersen
Keyword(s):  
General Practice ◽  
High Risk ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Preventive Health ◽  
Noncommunicable Disease ◽  
Noncommunicable Diseases ◽  
Health Checks

Abstract Background Preventive health checks targeted at the at-risk population can be a way of preventing noncommunicable diseases. However, evidence on patient preferences for preventive health checks is limited, especially among patients with a high risk of noncommunicable diseases. Objective To examine patient preferences for preventive health checks in Danish general practice, targeting persons at high risk of a noncommunicable disease. Methods The method used in this study was a discrete choice experiment (DCE) with five attributes: assess, advice, agree, assist and arrange. The attributes were inspired by the 5A model for behaviour change counselling but was altered for the purpose of this study to grasp the entirety of the general practice-based intervention. Moreover, the attribute levels were defined to resemble daily clinical practice. The experimental design of the DCE was an efficient Bayesian main effects design and the results were analysed using a random utility theory framework. Results A total of 148 patients completed the DCE. Patients at high risk of a noncommunicable disease have positive preferences for: giving brief explanations about own lifestyle, practicing shared decision-making with the general practitioner (GP), follow-up counselling with the GP after the preventive health check and scheduling a new appointment right after the preventive health check. Conclusions The results provide Danish GPs with evidence on their patients’ preferences towards preventive health checks which will enable the GPs to tailor these consultations. Moreover, the results suggest that pre-appointment measures, such as a health profile, may mediate a preference for more action-oriented attributes. Trial registration Registered at Clinical Trial Gov (Unique Protocol ID: TOFpilot2016, https://clinicaltrials.gov/ct2/show/NCT02797392?term=TOFpilot2016&rank=1). Prospectively registered on the 29th of April 2016.

The Two Town Study: A Comparison of Psychiatric Illness in Two Contrasting Western Australian Mining Towns

1975 ◽  
Vol 9 (2) ◽  
pp. 85-92 ◽  
Author(s):  
P. W. Burvill ◽  
Cecil B. Kidd
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Psychiatric Illness ◽  
Psychiatric Morbidity ◽  
The Other ◽  
Attendance Rate ◽  
Practice Survey ◽  
South West ◽  
General Practice Consultation ◽  
Western Australian

The results are presented of a survey of patients identified by their general practitioner as having conspicuous psychiatric morbidity, according to Kessel's (1960) Classification, during a three months general practice survey in two Western Australian towns, one, Gynalla, a new expanding town in the Pilbara area and the other, Jaburoo, an established economically stagnant town in the South West. The findings show a higher general practice consultation attendance rate for both sexes, and a higher rate of psychiatric illness among females, in Jaburoo than in Gynalla. In Gynalla psychiatric cases among women formed a disproportionately high percentage of all general practice attendances. The implications of these findings are discussed.

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