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Whitty, Jennifer A. 
ORCID: https://orcid.org/0000-0002-5886-1933, Stewart, Simon, Carrington, Melinda J., Calderone, Alicia, Marwick, Thomas, Horowitz, John D., Krum, Henry, Davidson, Patricia M., Macdonald, Peter S., Reid, Christopher and Scuffham, Paul A.
(2013)
Patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: Findings from the Which? trial.
PLoS One, 8 (3).
ISSN 1932-6203
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Abstract
Background Beyond examining their overall cost-effectiveness and mechanisms of effect, it is important to understand patient preferences for the delivery of different modes of chronic heart failure management programs (CHF-MPs). We elicited patient preferences around the characteristics and willingness-to-pay (WTP) for a clinic or home-based CHF-MP. Methodology/Principal Findings A Discrete Choice Experiment was completed by a sub-set of patients (n = 91) enrolled in the WHICH? trial comparing home versus clinic-based CHF-MP. Participants provided 5 choices between hypothetical clinic and home-based programs varying by frequency of nurse consultations, nurse continuity, patient costs, and availability of telephone or education support. Participants (aged 71±13 yrs, 72.5% male, 25.3% NYHA class III/IV) displayed two distinct preference classes. A latent class model of the choice data indicated 56% of participants preferred clinic delivery, access to group CHF education classes, and lower cost programs (p<0.05). The remainder preferred home-based CHF-MPs, monthly rather than weekly visits, and access to a phone advice service (p<0.05). Continuity of nurse contact was consistently important. No significant association was observed between program preference and participant allocation in the parent trial. WTP was estimated from the model and a dichotomous bidding technique. For those preferring clinic, estimated WTP was ≈AU$9-20 per visit; however for those preferring home-based programs, WTP varied widely (AU$15-105). Conclusions/Significance Patient preferences for CHF-MPs were dichotomised between a home-based model which is more likely to suit older patients, those who live alone, and those with a lower household income; and a clinic-based model which is more likely to suit those who are more socially active and wealthier. To optimise the delivery of CHF-MPs, health care services should consider their patients’ preferences when designing CHF-MPs.
| Item Type: | Article |
|---|---|
| Additional Information: | Copyright: © 2013 Whitty et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Health Economics Faculty of Medicine and Health Sciences > Research Groups > Respiratory and Airways Group Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) |
| Related URLs: | |
| Depositing User: | Pure Connector |
| Date Deposited: | 27 Apr 2016 13:00 |
| Last Modified: | 04 Jul 2023 13:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/58428 |
| DOI: | 10.1371/journal.pone.0058347 |
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