Preferences for Neurodevelopmental Follow-Up Care for Children: A Discrete Choice Experiment.

IF 3.4 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Pakhi Sharma, Sanjeewa Kularatna, Bridget Abell, Steven M McPhail, Sameera Senanayake
{"title":"Preferences for Neurodevelopmental Follow-Up Care for Children: A Discrete Choice Experiment.","authors":"Pakhi Sharma, Sanjeewa Kularatna, Bridget Abell, Steven M McPhail, Sameera Senanayake","doi":"10.1007/s40271-024-00717-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Identifying and addressing neurodevelopmental delays in children can be challenging for families and the healthcare system. Delays in accessing services and early interventions are common. The design and delivery of these services, and associated outcomes for children, may be improved if service provision aligns with families' needs and preferences for receiving care. The aim of this study is to identify families' preferences for neurodevelopmental follow-up care for children using an established methodology.</p><p><strong>Methods: </strong>We used a discrete choice experiment (DCE) to elicit families' preferences. We collected data from families and caregivers of children with neurodevelopmental needs. The DCE process included four stages. In stage 1, we identified attributes and levels to be included in the DCE using literature review, interviews, and expert advice. The finalised attributes were location, mode of follow-up, out-of-pocket cost per visit, mental health counselling for parents, receiving educational information, managing appointments, and waiting time. In stage 2, we generated choice tasks that contained two alternatives and a 'neither' option for respondents to choose from, using a Bayesian d-efficient design. These choice tasks were compiled in a survey that also included demographic questions. We conducted pre- and pilot tests to ensure the functionality of the survey and obtain priors. In stage 3, the DCE survey was administered online. We received 301 responses. In stage 4, the analysis was conducted using a latent class model. Additionally, we estimated the relative importance of attributes and performed a scenario analysis.</p><p><strong>Results: </strong>Two latent classes were observed. More families with full-time employees, higher incomes, postgraduate degrees, and those living in metropolitan areas were in class 1 compared with class 2. Class 1 families preferred accessing local public health clinics, face-to-face follow-up, paying AUD100 to AUD500, mental health support, group educational activities, health service-initiated appointments, and waiting < 3 months. Class 2 families disliked city hospitals when compared with private, preferred paying AUD100 or no cost, and had similar preferences regarding mental health support and wait times as class 1. However, no significant differences were noted in follow-up modality, receiving educational information, and appointment management. The relative importance estimation suggested that location was most important for class 1 (28%), whereas for class 2, cost accounted for nearly half of the importance when selecting an alternative. The expected uptake of follow-up care, estimated under three different hypothetical scenarios, may increase by approximately 24% for class 2 if an 'ideal' scenario taking into account preferences was implemented.</p><p><strong>Conclusion: </strong>This study offers insights into aspects that may be prioritised by health services and policymakers to improve the design and delivery of neurodevelopmental follow-up care for children. The findings may enhance the organisation and functioning of existing care programmes; and therefore, improve the long-term outcomes of children with neurodevelopmental needs and their families.</p>","PeriodicalId":51271,"journal":{"name":"Patient-Patient Centered Outcomes Research","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461776/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Patient-Patient Centered Outcomes Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40271-024-00717-3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/29 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Identifying and addressing neurodevelopmental delays in children can be challenging for families and the healthcare system. Delays in accessing services and early interventions are common. The design and delivery of these services, and associated outcomes for children, may be improved if service provision aligns with families' needs and preferences for receiving care. The aim of this study is to identify families' preferences for neurodevelopmental follow-up care for children using an established methodology.

Methods: We used a discrete choice experiment (DCE) to elicit families' preferences. We collected data from families and caregivers of children with neurodevelopmental needs. The DCE process included four stages. In stage 1, we identified attributes and levels to be included in the DCE using literature review, interviews, and expert advice. The finalised attributes were location, mode of follow-up, out-of-pocket cost per visit, mental health counselling for parents, receiving educational information, managing appointments, and waiting time. In stage 2, we generated choice tasks that contained two alternatives and a 'neither' option for respondents to choose from, using a Bayesian d-efficient design. These choice tasks were compiled in a survey that also included demographic questions. We conducted pre- and pilot tests to ensure the functionality of the survey and obtain priors. In stage 3, the DCE survey was administered online. We received 301 responses. In stage 4, the analysis was conducted using a latent class model. Additionally, we estimated the relative importance of attributes and performed a scenario analysis.

Results: Two latent classes were observed. More families with full-time employees, higher incomes, postgraduate degrees, and those living in metropolitan areas were in class 1 compared with class 2. Class 1 families preferred accessing local public health clinics, face-to-face follow-up, paying AUD100 to AUD500, mental health support, group educational activities, health service-initiated appointments, and waiting < 3 months. Class 2 families disliked city hospitals when compared with private, preferred paying AUD100 or no cost, and had similar preferences regarding mental health support and wait times as class 1. However, no significant differences were noted in follow-up modality, receiving educational information, and appointment management. The relative importance estimation suggested that location was most important for class 1 (28%), whereas for class 2, cost accounted for nearly half of the importance when selecting an alternative. The expected uptake of follow-up care, estimated under three different hypothetical scenarios, may increase by approximately 24% for class 2 if an 'ideal' scenario taking into account preferences was implemented.

Conclusion: This study offers insights into aspects that may be prioritised by health services and policymakers to improve the design and delivery of neurodevelopmental follow-up care for children. The findings may enhance the organisation and functioning of existing care programmes; and therefore, improve the long-term outcomes of children with neurodevelopmental needs and their families.

Abstract Image

对儿童神经发育后续护理的偏好:离散选择实验。
导言:识别和解决儿童神经发育迟缓问题对于家庭和医疗保健系统来说都是一项挑战。延迟获得服务和早期干预是常见现象。如果服务的提供与家庭的需求和接受护理的偏好相一致,那么这些服务的设计和提供以及儿童的相关结果都可能得到改善。本研究的目的是利用一种成熟的方法来确定家庭对儿童神经发育后续护理的偏好:我们采用离散选择实验(DCE)来了解家庭的偏好。我们从有神经发育需求儿童的家庭和看护者那里收集了数据。离散选择实验过程包括四个阶段。在第一阶段,我们通过文献回顾、访谈和专家建议,确定了将纳入离散选择实验的属性和水平。最终确定的属性包括地点、随访方式、每次就诊的自付费用、家长心理健康辅导、接受教育信息、预约管理和等候时间。在第二阶段,我们采用贝叶斯 d-效率设计法生成了包含两个备选方案和一个 "都不是 "选项的选择任务,供受访者选择。这些选择任务被编入一份调查问卷中,其中还包括人口统计学问题。我们进行了预先测试和试点测试,以确保调查的功能性并获得先验。在第 3 阶段,我们在线进行了 DCE 调查。我们收到了 301 份回复。在第 4 阶段,我们使用潜类模型进行分析。此外,我们还估算了属性的相对重要性,并进行了情景分析:观察到两个潜类。与第 2 类家庭相比,第 1 类家庭中全职雇员、高收入、研究生学历和居住在大都市地区的家庭更多。第一类家庭更喜欢去当地的公共卫生诊所、面对面随访、支付 100 澳元至 500 澳元、心理健康支持、集体教育活动、由卫生服务机构发起的预约,以及等待时间小于 3 个月。与私立医院相比,二类家庭不喜欢市立医院,喜欢支付 100 澳元或免费,在心理健康支持和等待时间方面的偏好与一类家庭相似。然而,在随访方式、接受教育信息和预约管理方面没有发现明显的差异。相对重要性估算表明,地点对 1 类最重要(28%),而对 2 类来说,费用占了选择替代方案时重要性的近一半。根据三种不同的假设情况进行估算,如果实施一种考虑到偏好的 "理想 "方案,后续护理的预期接受率在 2 级中可能会增加约 24%:本研究为医疗服务机构和政策制定者提供了改进儿童神经发育后续治疗的设计和实施的优先事项。研究结果可能会加强现有护理计划的组织和运作,从而改善有神经发育需求的儿童及其家庭的长期结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Patient-Patient Centered Outcomes Research
Patient-Patient Centered Outcomes Research HEALTH CARE SCIENCES & SERVICES-
CiteScore
6.60
自引率
8.30%
发文量
44
审稿时长
>12 weeks
期刊介绍: The Patient provides a venue for scientifically rigorous, timely, and relevant research to promote the development, evaluation and implementation of therapies, technologies, and innovations that will enhance the patient experience. It is an international forum for research that advances and/or applies qualitative or quantitative methods to promote the generation, synthesis, or interpretation of evidence. The journal has specific interest in receiving original research, reviews and commentaries related to qualitative and mixed methods research, stated-preference methods, patient reported outcomes, and shared decision making. Advances in regulatory science, patient-focused drug development, patient-centered benefit-risk and health technology assessment will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in The Patient may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances. All manuscripts are subject to peer review by international experts.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信