Abstract
BackgroundAlthough Chinese government has dedicated the past decades to treating chronic diseases by primary healthcare system, many more residents are apt to choose higher-tier facilities to treat minor chronic diseases. Understanding residents’ preferences for chronic disease management in primary care facilities can bridge the gap between residents’ choices and policy implementation. This study aims to elicit residents’ preferences for chronic disease management in primary care facilities in the hypothetical minor chronic disease scenario.MethodsSix hundred eighty residents were administered a discrete choice experiment that elicited preferences for chronic disease management in primary care facilities. Services attributes were service mode, treatment measure, out-of-pocket expenditure (OOP), traveling time to healthcare facility and title of physician. Mixed logit models were used to estimate stated preferences and willingness to pay for attributes. WTP confidence intervals were estimated by the delta method.ResultsA total of 94.44% of the completed questionnaires were valid (680 of 720 respondents). The participants preferred chronic disease management service with modern medicine, traveling time ≤ 30mins, and less OOP expenditure. Compared with Traditional Chinese Medicine (TCM), residents prefer modern medicine, willing to pay 155.53 CNY ($21.97) to change from TCM to modern medicine. Compensation about 86.02 CNY ($12.15) was needed to enable residents to change the choice of the nearer primary care facility to a further one. Integrated medicine in community clinics by experts was residents’ most preferred scenario while TCM in the tertiary hospital was their least preferred one.ConclusionIn order to increase the utilization of primary healthcare services in chronic diseases management, policy makers need to concern more about the services of medical treatment type, price and convenience. Therefore, we advise policy makers to provide nearer primary healthcare services for residents especially for residents in surrounding areas. Furthermore, balancing the resource allocation between Traditional Chinese Medicine and modern medicine is worthy of consideration.
Highlights
Chinese government has dedicated the past decades to treating chronic diseases by primary healthcare system, many more residents are apt to choose higher-tier facilities to treat minor chronic diseases
We considered the availability of Traditional Chinese Medicine (TCM) and integrated medicine (i.e., TCM and modern medicine combined service) in addition to modern medicine service in the attribute of medical treatment type
Willingness-to-pay for healthcare services The WTP related to the change from TCM service to modern medicine service was the largest, residents were willing to pay 155.53 CNY ($21.97)
Summary
Chinese government has dedicated the past decades to treating chronic diseases by primary healthcare system, many more residents are apt to choose higher-tier facilities to treat minor chronic diseases. Understanding residents’ preferences for chronic disease management in primary care facilities can bridge the gap between residents’ choices and policy implementation. World Health Organization reported that about 41 million people died of various chronic diseases in 2016, accounting for 71% of the total deaths [1]. In China, a national report stated that chronic diseases were attributable to 88.5% of all deaths in 2019 [3]. Following the lessons from western countries, China has established a de facto multi-tiered healthcare system (i.e., tertiary hospitals, secondary hospitals, and primary care facilities) with an emphasis on the role of primary care facilities (e.g., community health centers, clinics) in chronic disease management [6]. It reflects the unexpected fact that residents show less preference for chronic disease management in primary care facilities [9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
