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首页> 外文期刊>Annals of family medicine >What patients want from primary care consultations: a discrete choice experiment to identify patients' priorities.
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What patients want from primary care consultations: a discrete choice experiment to identify patients' priorities.

机译:患者从基层医疗咨询中需要什么:一项离散选择实验,用于确定患者的优先事项。

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PURPOSE: The consultation is fundamental to the delivery of primary care, but different ways of organizing consultations may lead to different patient experiences in terms of access, continuity, technical quality of care, and communication. Patients' priorities for these different issues need to be understood, but the optimal methods for assessing priorities are unclear. This study used a discrete choice experiment to assess patients' priorities. METHODS: We surveyed patients from 6 family practices in England. The patients chose between primary care consultations differing in attributes such as ease of access (wait for an appointment), choice (flexibility of appointment times), continuity (physician's knowledge of the patient), technical quality (thoroughness of physical examination), and multiple aspects of patient-centered care (interest in patient's ideas, inquiry about patient's social and emotional well-being, and involvement of patient in decision making). We used probit models to assess the relative priority patients placed on different attributes and to estimate how much they were willing to pay for them. RESULTS: Analyses were based on responses from 1,193 patients (a 53% response rate). Overall, patients were willing to pay the most for a thorough physical examination (Dollars 40.87). The next most valued attributes of care were seeing a physician who knew them well (Dollars 12.18), seeing a physician with a friendly manner (Dollars 8.50), having a reduction in waiting time of 1 day (Dollars 7.22), and having flexibility of appointment times (Dollars 6.71). Patients placed similar value on the different aspects of patient-centered care (Dollars 12.06-Dollars 14.82). Responses were influenced by the scenario in which the decision was made (minor physical problem vs urgent physical problem vs ambiguous physical or psychological problem) and by patients' demographic characteristics. CONCLUSIONS: Although patient-centered care is important to patients, they may place higher priority on the technical quality of care and continuity of care. Discrete choice experiments may be a useful method for assessing patients' priorities in health care.
机译:目的:咨询是提供初级保健的基础,但是组织咨询的不同方式可能会导致患者在获得,连续性,护理的技术质量和沟通方面的不同体验。需要了解患者针对这些不同问题的优先级,但是尚不清楚评估优先级的最佳方法。本研究使用离散选择实验评估患者的优先级。方法:我们调查了英格兰6家家庭诊所的患者。患者在基层医疗咨询中进行选择,这些咨询的属性各不相同,例如可及性(等待预约),选择(预约时间的灵活性),连续性(医师对患者的了解),技术质量(体检的强度)和多项以患者为中心的护理方面(对患者想法的兴趣,对患者社会和情感健康的询问以及患者参与决策的兴趣)。我们使用概率模型评估了处于不同属性上的相对优先级患者,并估计了他们愿意为他们支付多少费用。结果:分析是基于对1,193例患者的反应(53%的反应率)。总体而言,患者愿意为全面的身体检查支付最高的费用(美元40.87)。护理的第二个最有价值的属性是看医生对他们了解得很好(美元12.18),看待医生的态度友好(美元8.50),等待时间减少了1天(美元7.22)以及灵活性高。约会时间(美元6.71)。患者在以患者为中心的护理的各个方面都具有相似的价值(美元12.06-美元14.82)。做出决定的情况(次要身体问题,紧急身体问题,不明确的身体或心理问题)和患者的人口统计学特征都会影响响应。结论:尽管以患者为中心的护理对患者很重要,但他们可能会把护理的技术质量和护理的连续性放在优先位置。离散选择实验可能是评估患者医疗保健优先级的有用方法。

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