Clark, Michael, Moro, Domenico and Szczepura, Ala. (2009) Balancing patient preferences and clinical needs : community versus hospital based care for patients with suspected DVT. Health Policy, Vol.90 (No.2-3). pp. 313-319. ISSN 0168-8510

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Abstract

Objective: To establish patients' preferences and willingness to pay (WTP) for different service models for suspected deep vein thrombosis (DVT).

Methods: We analysed patient responses to a discrete choice experiment (DCE) questionnaire which had been targeted at patients in Leicester, UK.

The questionnaire elicited preferences/WTP for attributes of DVT provision including speed of diagnosis; access; continuity, of care; and minimizing hospital visits. Additionally we evaluated trade-offs between clinical and service attributes. We analysed responses from 256 patients with suspected DVT (65% response rate).

Results: Respondents are WTP 4.82 pound per extra hour of dedicated DVT service provision; 17.12 pound per hospital visit avoided; 115.73 pound per day's reduction in diagnostic wait; and 179.32 pound for 'much' not 'some' continuity, or 56.88 pound for 'some' not 'lack' of continuity in nursing.

Conclusions: Research evaluating different DVT service models usually reports on clinical efficacy in centres of excellence. Results show prompt diagnosis is valued by patients and may improve efficacy by reducing unnecessary anticoagulation. However, patients value 'process' measures such as continuity of care also. To ensure optimal provision, clinical benefit measurement ought to be augmented with information on patients' preferences. (C) 2008 Published by Elsevier Ireland Ltd.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Patient participation, Clinical medicine -- Decision making, Blood coagulation disorders -- Hospital care, Hospital care, Community health services
Journal or Publication Title:	Health Policy
Publisher:	Elsevier Ireland Ltd.
ISSN:	0168-8510
Official Date:	May 2009
Volume:	Vol.90
Number:	No.2-3
Number of Pages:	7
Page Range:	pp. 313-319
Identification Number:	10.1016/j.healthpol.2008.09.010
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Leicester City West Primary Care Trust (LCWPCT)
URI:	http://wrap.warwick.ac.uk/id/eprint/27991

Data sourced from Thomson Reuters' Web of Knowledge

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