Urban-rural differences in preferences for traditional Chinese medicine services among chronic disease patients: a discrete choice experiment.

IF 3.3 2区 医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE
Fan Jiang, Yuting Feng, Wen Zong, Jianing Xue, Wanning Chen, Liu Qizhi, Jiao Zhang, Aijun Xu
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Abstract

Background: With the increasing prevalence of chronic diseases, the demand for medical services from chronic disease patients has become diversified and personalized. The advantages and role of traditional Chinese medicine in the prevention and treatment of chronic diseases gradually emerging. The preferences and willingness to pay for traditional Chinese medicine services (TCMS) among patients with chronic diseases, as well as any disparities between urban and rural patients, have not been examined in past studies.

Objective: This study aimed to investigate the preferences of chronic disease patients for TCMS, explore the value/importance that patients place on different treatment attributes, and evaluate whether there are urban-rural differences in their preferences and willingness to pay for TCMS.

Methods: A total of 317 patients from Jiangsu Province, China participated in a discrete choice experiment that elicited the preferences for TCMS. The choice questions were constructed by six attributes: out-of-pocket (OOP) cost, institution, medical provider, treatment method, treatment duration, treatment efficacy. Mixed logit models were used to estimate the stated preference and marginal willingness to pay for each attribute.

Results: The choice preferences of chronic disease patients for TCMS in this study were influenced by the four attributes: institution, treatment method, and treatment efficacy, and OOP cost. Improvements in treatment efficacy were the most concerning, followed by being treated in traditional Chinese medicine (TCM) hospital. Patients were willing to pay more to get better treatment outcomes. Compared with primary care institutions, patients were willing to pay more for treatment in TCM hospitals. The preferences for economic attribute (OOP cost) varied between urban and rural areas, and rural patients tended to favor scenarios that imposed a lower economic burden on them.

Conclusion: The chronic disease patients' preferences for TCMS were determined mainly by treatment efficacy but also by institution, treatment method and OOP cost. The urban-rural difference in preference identified in this study highlights that effective policy interventions should consider the characteristics of patients' demand in different regions.

慢性病患者对中医药服务偏好的城乡差异:离散选择实验。
背景:随着慢性病发病率的不断上升,慢性病患者对医疗服务的需求呈现多样化、个性化的趋势。中医药在慢性病防治中的优势和作用逐渐显现。以往的研究尚未对慢性病患者对中医药服务的偏好和支付意愿,以及城乡患者之间的差异进行研究:本研究旨在调查慢性病患者对中医药服务的偏好,探讨患者对不同治疗属性的价值/重要性,并评估他们对中医药服务的偏好和支付意愿是否存在城乡差异:方法:来自中国江苏省的 317 名患者参加了一项离散选择实验,以了解他们对 TCMS 的偏好。选择题由六个属性构成:自付费用(OOP)、医疗机构、医疗服务提供者、治疗方法、疗程、疗效。混合对数模型用于估算每个属性的陈述偏好和边际支付意愿:结果:在本研究中,慢性病患者对中医药治疗的选择偏好受四个属性的影响:机构、治疗方法、疗效和门诊费用。患者最关心的是疗效的改善,其次是在中医医院接受治疗。患者愿意支付更多费用以获得更好的治疗效果。与基层医疗机构相比,患者愿意为在中医医院接受治疗支付更多费用。对经济属性(自费项目费用)的偏好在城市和农村地区有所不同,农村患者倾向于选择给他们带来较低经济负担的方案:结论:慢性病患者对中医医疗服务的偏好主要取决于疗效,但也取决于医疗机构、治疗方法和门诊费用。本研究发现的城乡偏好差异突出表明,有效的政策干预应考虑不同地区患者的需求特点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Complementary Medicine and Therapies
BMC Complementary Medicine and Therapies INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
6.10
自引率
2.60%
发文量
300
审稿时长
19 weeks
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