A Discrete Choice Experiment to Examine the Preferences of Patients With Cancer and Their Willingness to Pay for Different Types of Health Care Appointments

Authors: Shu Fen Wong MBBS, B Med Sci, FRACP a , a , Richard Norman PhD, MSc a , Trisha Lynette Dunning AM, RN, CDE, MEd, PhD a , David Michael Ashley MBBS, FRACP, PhD a , a , Mustafa Khasraw MBBS, FRACP, MD a , Theresa Margaret Hayes MBBS, B Med Sci, FRACP a , Ian Collins MB, BCh, BAO, MSc, FRACP a and Paula Kate Lorgelly PhD, PGCAP a
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  • a From the Department of Medicine, University Hospital Geelong, Deakin University, Geelong; Andrew Love Cancer Centre, University Hospital Geelong, Geelong; School of Public Health, Curtin University, Perth; School of Nursing and Midwifery, University Hospital Geelong, Deakin University, Geelong; St John of God Hospital, Warrnambool; The Greater Green Triangle Clinical School, Deakin University School of Medicine, Warrnambool; and Centre of Health Economics, Monash University, Melbourne, Australia.
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Background: This study sought to understand the preferences of patients with cancer and the trade-offs between appointment attributes using discrete choice experiment (DCE). Methods and Study Design: Patients with cancer at 3 hospitals completed a self-administered DCE. Each scenario described 6 attributes: expertise of health care professionals (HCPs), familiarity of doctors with patients' medical history, waiting time, accompaniment by family/friends, travel time, and out-of-pocket costs. Patient preferences were estimated using logistic regression. Willingness to pay (WTP) estimates were derived from regression coefficients. Results: Of 512 patients contacted, 185 returned the questionnaire. The mean age was 61 years, and 60% of respondents were female. The mean time since cancer diagnosis was 34 months, 90% had received treatment; and 61% had early-stage disease. The most important attributes were expertise and familiarity of doctors with patients' medical history; distance traveled was least likely to influence patient preferences. The WTP analysis estimated that patients were willing to pay $680 (95% CI, 470–891) for an appointment with a specialist, $571 (95% CI, 388–754) for doctors familiar with their history, $422 (95% CI, 262–582) for shorter waiting times, $399 (95% CI, 249–549) to be accompanied by family/friends, and $301 (95% CI, 162–441) for shorter traveling times. Male patients had a stronger preference for accompaniment by family/friends. The expertise of HCP was the most important attribute for patients regardless of geographic remoteness. Conclusions: Our study can assist the development of patient-centered health care models that improve patient access to experienced HCPs, support the role of primary care providers during the cancer journey, and educate patients about the roles of non-oncology HCPs to cope with increasing demand for cancer care.

Correspondence: Shu Fen Wong, MBBS, B Med Sci, FRACP, Andrew Love Cancer Centre, University Hospital Geelong, 70 Swanston Street, Geelong 3220, Australia. E-mail: shufen.wong81@gmail.com

Supplementary Materials

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