How Do Type 2 Diabetes Patients Value Urban Integrated Primary Care in China? Results of a Discrete Choice Experiment

Xin Wang, Kuimeng Song, Paiyi Zhu, Pim Valentijn, Yixiang Huang and Stephen Birch
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Xin Wang: School of Public Health, Health Development Research Center, Sun Yat-Sen University, Guangzhou 510080, China
Kuimeng Song: Shandong Institute of Medicine and Health Information, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250012, China
Paiyi Zhu: School of Public Health, Health Development Research Center, Sun Yat-Sen University, Guangzhou 510080, China
Pim Valentijn: Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands
Yixiang Huang: School of Public Health, Health Development Research Center, Sun Yat-Sen University, Guangzhou 510080, China
Stephen Birch: Centre for the Business and Economics of Health, University of Queensland, Brisbane, QLD 4072, Australia

IJERPH, 2019, vol. 17, issue 1, 1-12

Abstract: Objectives: Fragmented healthcare in China cannot meet the needs of the growing number of type 2 diabetes patients. The World Health Organization proposed an integrated primary care approach to address the needs of patients with chronic conditions. This study aims to measure type 2 diabetes patients’ preferences for urban integrated primary care in China. Methods: A discrete choice experiment was designed to measure type 2 diabetes patient preferences for seven priority attributes of integrated care. A two-stage sampling survey of 307 type 2 diabetes mellitus (T2DM) patients in 16 community health stations was carried out. Interviews were conducted to explore the reasons underpinning the preferences. A logit regression model was used to estimate patients’ willingness to pay and to analyze the expected impact of potential policy changes. Results: Travel time to care providers and experience of care providers are the most valued attributes for respondents rather than out-of-pocket cost. Attention to personal situation, the attentiveness of care providers, and the friendliness and helpfulness of staff were all related to interpersonal communication between patients and health care providers. Accurate health information and multidisciplinary care were less important attributes. Conclusions: The study provides an insight into type 2 diabetes patients’ needs and preferences of integrated primary care. People-centered interventions, such as increasing coverage by family doctor and cultivating mutual continuous relationships appear to be key priorities of policy and practice in China.

Keywords: primary care; discrete choice experiment; type 2 diabetes; preference (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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