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" Using conjoint analysis to estimate patients' selection preferences for hospitals and surgeons "
Justin J. Coran
Koropeckyj-Cox, Tanya
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Latin Dissertation
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| Language of Document
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English
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| Record Number
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804415
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| Doc. No
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TL49246
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| Call number
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1875225010; 10408808
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| Main Entry
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Salem, Basil
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| Title & Author
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Using conjoint analysis to estimate patients' selection preferences for hospitals and surgeons\ Justin J. CoranKoropeckyj-Cox, Tanya
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| College
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University of Florida
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| Date
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2015
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| Degree
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Ph.D.
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| field of study
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Sociology
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| student score
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2015
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| Page No
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264
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| Note
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Place of publication: United States, Ann Arbor; ISBN=978-1-369-59788-2
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| Abstract
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Prior to a clinical encounter, patients face a complex decision process to select an appropriate doctor or hospital for their medical care. Health disparities may result from sub-optimal decision-making if patients do not have enough support to understand all of their options for care. In addition, too many available hospital or provider options could result in decisional conflict, further exacerbating new disparities in care. The purpose of this study was to gain new insight on how people tradeoff among desirable and undesirable health care attributes when selecting hospitals or surgeons for an elective medical procedure. A stratified cross-sectional convenience sample of subjects (N=2,035) were invited from an Internet survey panel to complete one of two choicebased conjoint surveys. Participants selected either a hospital or orthopedic surgeon based on nine attributes. Conjoint attributes and corresponding levels were developed from a new conceptual framework illustrating health care preferences (i.e., The PMO Health Care Influence Mix). Hierarchical Bayes estimation was used to fit conjoint utilities to individual participants and capture heterogeneity between segments of respondents. The relative importances (RI) of different attributes were examined using Mann-Whitney U and Kruskal-Wallis tests. Market simulation methods provided insight on the implications of part-worth utility values. Participants placed the most importance weight on out-of-pocket cost for both decision tasks (RI of 24.5% for hospitals, <i>P</i> < 0.001; RI of 21.1% for surgeons, <i>P</i> < 0.003). The second and third most important factors were previous health care experience (RI of 13.9% for hospitals, <i>P</i> < 0.001; RI of 18.4% for surgeons, <i>P</i> < 0.024) and a recommendation from an established primary care provider (RI of 15.8% for hospitals, <i>P</i> < 0.001; RI of 14.4% for surgeons, <i>P</i> < 0.002). Market simulations suggest cost does not dominate decision-making since respondents were willing to select more expensive hospitals and providers in order to access greater shared decision-making and collaboration. Participants reported higher decisional conflict if they needed to select a surgeon. Highly conflicted individuals may increase the importance of out-of-pocket cost. People with lower decisional conflict were observed with higher RI scores for communication-related attributes.
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| Subject
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Medicine; Public health; Sociology
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| Descriptor
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Social sciences;Health and environmental sciences;Conjoint analysis;Hospitals;Medical decision making;Patients;Surgeons
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Koropeckyj-Cox, Tanya
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SociologyUniversity of Florida
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