The Value of Treatment Processes in Germany: A Discrete Choice Experiment on Patient Preferences in Complementary and Conventional Medicine

Daniela Adam (), Theresa Keller, Axel Mühlbacher, Maximilian Hinse, Katja Icke, Michael Teut, Benno Brinkhaus and Thomas Reinhold
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Daniela Adam: Humboldt-Universität zu Berlin
Theresa Keller: Humboldt-Universität zu Berlin
Axel Mühlbacher: Hochschule Neubrandenburg
Maximilian Hinse: Humboldt-Universität zu Berlin
Katja Icke: Humboldt-Universität zu Berlin
Michael Teut: Humboldt-Universität zu Berlin
Benno Brinkhaus: Humboldt-Universität zu Berlin
Thomas Reinhold: Humboldt-Universität zu Berlin

The Patient: Patient-Centered Outcomes Research, 2019, vol. 12, issue 3, No 8, 349-360

Abstract: Abstract Background The effects of health interventions are often complex, and it is argued that they comprise more than pure changes in clinical parameters. Aspects of the treatment process, so-called ‘benefits beyond health’, are often overlooked in the evaluation of health interventions but can be of value to the patients. Objectives The aim of this study was to assess patients’ preferences and willingness to pay regarding the treatment process and its attributes in patients using acupuncture, homeopathy or general medicine (GM). Methods A systematic literature search, six semi-structured interviews and a stakeholder involvement were conducted to determine the attributes of the treatment process. Five process attributes and one cost attribute were used to construct the experimental design of the discrete choice experiment (DCE) (6 × 3), a cross sectional survey method. Patients were recruited by outpatient physicians practicing in Berlin and Munich, Germany. Process attributes were effects-coded. Data were analyzed in a conditional logit regression. Results Data from 263 patients were analyzed. DCE results showed that the treatment process attributes ‘active listening’ and ‘time’ were most relevant to all patients. Preferences for the attributes ‘holistic treatment’ (more relevant to the acupuncture and homeopathy groups) and ‘information’ (more relevant to the GM group) seemed to differ slightly between the groups. Willingness-to-pay values were higher in the acupuncture and homeopathy groups. Conclusions The time physicians take and the extent to which they listen attentively are most important and are equally important to all patients. These results may contribute to the debate about more patient-centered healthcare. They support a strengthening of medical consultations in the German healthcare system. We suggest giving physicians the opportunity to spend more time with their patients, which may be achieved by changing the general conditions of remuneration (e.g., improved reimbursement of medical consultations). German Clinical Trial Register DRKS00013160.

Date: 2019
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DOI: 10.1007/s40271-018-0353-1

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