Abstract
Objectives: This study aims to elicit the relative importance of treatment attributes that influence residents’ choice, assuming they are suffering severe non-communicable diseases (NCDs), to explore how they make trade-offs between these attributes and to estimate the monetary value placed on different attributes and attribute levels. Methods: A discrete choice experiment (DCE) was conducted with adults over 18 years old in China. Preferences were evaluated based on four treatment attributes: care provider, mode of service, distance to practice and cost. A mixed logit model was used to analyze the relative importance of the four attributes and to calculate the willingness to pay (WTP) for a changed attribute level. Results: A total of 93.47% (2019 of 2160) respondents completed valid questionnaires. The WTP results suggested that participants would be willing to pay CNY 822.51 (USD 124.86), CNY 470.54 (USD 71.41) and CNY 68.20 (USD 10.35) for services provided by experts, with integrated traditional Chinese medicine (TCM) and Western medicine (WM) and with a service distance <=30 min, respectively. Conclusions: The results suggested that mode of service, care provider, distance to practice and cost should be considered in priority-setting decisions. The government should strengthen the curative service capability in primary health facilities and give full play to the role of TCM in the prevention and treatment of severe chronic diseases.
Highlights
Interwoven with an ageing population, behavioral changes [1,2,3] and rapid urbanization [4,5], non-communicable diseases (NCDs), like cardiovascular diseases and hypertension, have been a major threat to public health worldwide
Under the assumption of severe chronic disease, participants preferred services provided by experts, services located at a relatively short distance and integrated traditional Chinese medicine (TCM) and Western medicine (WM) services
The results indicated that policymakers should fully consider the positive role of integrated TCM and WM services and expert treatment services
Summary
Interwoven with an ageing population, behavioral changes [1,2,3] and rapid urbanization [4,5], non-communicable diseases (NCDs), like cardiovascular diseases and hypertension, have been a major threat to public health worldwide. More than 300 million chronically ill patients have been diagnosed in 2018 in China; especially the incidence of cardiovascular and cerebrovascular diseases increased from 28.28% in 2008 to 36.67% in 2012 [6]. Severe NCDs have shown a trend of development in young adults and have begun to affect middle-aged people [7]. The Chinese government had taken a series of measures to alleviate the threat from NCDs ten years ago. The primary healthcare system was designated as a means of addressing the emerging dual burden of NCDs and
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