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Public preferences for health care facilities in rural China: A discrete choice experiment

Author

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  • Liu, Yun
  • Kong, Qingxia
  • de Bekker-Grob, Esther W.

Abstract

To successfully tackle the problems with the underutilization of primary care in rural China, it is important to align resource allocation with the preferences of the rural population. However, despite growing interest in the factors influencing the rural population's choice of facility, it is unclear how much weight should be placed on these factors, especially under different scenarios of disease severity. In the first study to elicit quantified trade-offs among influential factors in choosing health care facilities, we carried out a discrete choice experiment (DCE) in rural China. We used a Bayesian efficient design to construct 36 choice sets, and then divided them into three blocks. Each block formed one version of questionnaire that contained 12 choice questions. Each question was assigned a hypothetical perceived severity scenario of either minor or severe disease. 559 Rural residents completed the DCE through face-to-face interviews in December 2017–March 2018. We used mixed logit models to analyze the choice data. The factors regarding the availability and affordability of a facility, such as visit time, travel time, and out-of-pocket cost, were highly valued. When the facilities changed simultaneously from the worst to the best case, a huge increase (from 4.8% to 66.5%) in the predicted choice probability of choosing to visit a facility was observed under perceived minor disease scenario, whereas there was no significant change under perceived severe disease scenario. Improvements to drug availability, medical professional skill and equipment in rural primary care system can induce potential medical care seeking, and redirect patient flow from higher level hospitals to primary level. Especially, township health centers, which provide service to the residents in rural communities, have great potential to be the ideal facilities for first-contact care.

Suggested Citation

  • Liu, Yun & Kong, Qingxia & de Bekker-Grob, Esther W., 2019. "Public preferences for health care facilities in rural China: A discrete choice experiment," Social Science & Medicine, Elsevier, vol. 237(C), pages 1-1.
  • Handle: RePEc:eee:socmed:v:237:y:2019:i:c:22
    DOI: 10.1016/j.socscimed.2019.112396
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    References listed on IDEAS

    as
    1. Xichenhui Qiu & Janet W H Sit & Fung Kuen Koo, 2018. "The influence of Chinese culture on family caregivers of stroke survivors: A qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(1-2), pages 309-319, January.
    2. Mickael Bech & Dorte Gyrd‐Hansen, 2005. "Effects coding in discrete choice experiments," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1079-1083, October.
    3. Esther Bekker-Grob & Bas Donkers & Marcel Jonker & Elly Stolk, 2015. "Sample Size Requirements for Discrete-Choice Experiments in Healthcare: a Practical Guide," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(5), pages 373-384, October.
    4. Michael Clark & Domino Determann & Stavros Petrou & Domenico Moro & Esther Bekker-Grob, 2014. "Discrete Choice Experiments in Health Economics: A Review of the Literature," PharmacoEconomics, Springer, vol. 32(9), pages 883-902, September.
    5. Wang, Xiuli & Yang, Huazhen & Duan, Zhanqi & Pan, Jay, 2018. "Spatial accessibility of primary health care in China: A case study in Sichuan Province," Social Science & Medicine, Elsevier, vol. 209(C), pages 14-24.
    6. Determann, Domino & Lambooij, Mattijs S. & de Bekker-Grob, Esther W. & Hayen, Arthur P. & Varkevisser, Marco & Schut, Frederik T. & Wit, G. Ardine de, 2016. "What health plans do people prefer? The trade-off between premium and provider choice," Social Science & Medicine, Elsevier, vol. 165(C), pages 10-18.
    7. Bliemer, Michiel C.J. & Rose, John M., 2013. "Confidence intervals of willingness-to-pay for random coefficient logit models," Transportation Research Part B: Methodological, Elsevier, vol. 58(C), pages 199-214.
    8. Lancsar, Emily & Louviere, Jordan & Flynn, Terry, 2007. "Several methods to investigate relative attribute impact in stated preference experiments," Social Science & Medicine, Elsevier, vol. 64(8), pages 1738-1753, April.
    9. Peyron, Christine & Pélissier, Aurore & Béjean, Sophie, 2018. "Preference heterogeneity with respect to whole genome sequencing. A discrete choice experiment among parents of children with rare genetic diseases," Social Science & Medicine, Elsevier, vol. 214(C), pages 125-132.
    10. Louviere, Jordan J. & Lancsar, Emily, 2009. "Choice experiments in health: the good, the bad, the ugly and toward a brighter future," Health Economics, Policy and Law, Cambridge University Press, vol. 4(4), pages 527-546, October.
    11. Jorien Veldwijk & Mattijs S Lambooij & Esther W de Bekker-Grob & Henriëtte A Smit & G Ardine de Wit, 2014. "The Effect of Including an Opt-Out Option in Discrete Choice Experiments," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-9, November.
    12. Yun Liu & Qingxia Kong & Shasha Yuan & Joris van de Klundert, 2018. "Factors influencing choice of health system access level in China: A systematic review," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-21, August.
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    6. Erping Jia & Yuanyuan Gu & Yingying Peng & Xianglin Li & Xiao Shen & Mingzhu Jiang & Juyang Xiong, 2020. "Preferences of Patients with Non-Communicable Diseases for Primary Healthcare Facilities: A Discrete Choice Experiment in Wuhan, China," IJERPH, MDPI, vol. 17(11), pages 1-15, June.
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