Do patients’ preferences prevail in hospital selection? a comparison between discrete choice experiments and revealed hospital choice

Benjamin H. Salampessy*, David Ikkersheim, France R.M. Portrait, Xander Koolman

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: In patient choice, patients are expected to select the provider that best fits their preferences. In this study, we assess to what extent the hospital choice of patients in practice corresponds with their preferred choice. Methods: Dutch patients with breast cancer (n = 631) and cataract (n = 1109) were recruited. We employed a discrete choice experiment (DCE) per condition to measure stated preferences and predict the distribution of patients across four hospitals. Each DCE included five attributes: patient experiences, a clinical outcome indicator, waiting time, travel distance and whether the hospital had been recommended (e.g., by the General Practitioner (GP)). Revealed choices were derived from claims data. Results: Hospital quality was valued as most important in the DCE; the largest marginal rates of substitution (willingness to wait) were observed for the clinical outcome indicator (breast cancer: 38.6 days (95% confidence interval (95%CI): 32.9–44.2); cataract: 210.5 days (95%CI: 140.8–280.2)). In practice, it was of lesser importance. In revealed choices, travel distance became the most important attribute; it accounted for 85.5% (breast cancer) and 95.5% (cataract) of the log-likelihood. The predicted distribution of patients differed from that observed in practice in terms of absolute value and, for breast cancer, also in relative order. Similar results were observed in population weighted analyses. Discussion: Study findings show that patients highly valued quality information in the choice for a hospital. However, in practice these preferences did not prevail. Our findings suggest that GPs played a major role and that patients mostly ended up selecting the nearest hospital.

Original languageEnglish
Article number1136
Pages (from-to)1-13
Number of pages13
JournalBMC health services research
Volume22
DOIs
Publication statusPublished - 8 Sept 2022

Bibliographical note

Funding Information:
Ethical approval for this study was given by the nationwide ethics committee (Centrale Commissie Mensgebonden Onderzoek (CCMO)) as part of receiving the funding by ZonMw, the Dutch organization for health research and development (grant number: 49400016).

Funding Information:
Financial support for this study was provided entirely by a grant from ZonMw the Dutch organization for health research and development (grant number: 49400016). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • Choice behavior
  • Discrete choice experiment
  • Hospital
  • Patient preferences
  • Quality of care
  • Revealed and stated preferences

Fingerprint

Dive into the research topics of 'Do patients’ preferences prevail in hospital selection? a comparison between discrete choice experiments and revealed hospital choice'. Together they form a unique fingerprint.

Cite this