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Balancing patient preferences and clinical needs : community versus hospital based care for patients with suspected DVT
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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. doi:10.1016/j.healthpol.2008.09.010
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Official URL: http://dx.doi.org/10.1016/j.healthpol.2008.09.010
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 | ||||
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| Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| 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 | ||||
| Dates: |
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| Volume: | Vol.90 | ||||
| Number: | No.2-3 | ||||
| Number of Pages: | 7 | ||||
| Page Range: | pp. 313-319 | ||||
| DOI: | 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) |
Data sourced from Thomson Reuters' Web of Knowledge
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