Patient preferences for facility-based management of hypertension and diabetes in rural Uganda: a discrete choice experiment
Objective To explore how respondents with common chronic conditions—hypertension (HTN) and diabetes mellitus (DM)—make healthcare-seeking decisions.Setting Three health facilities in Nakaseke District, Uganda.Design Discrete choice experiment (DCE).Participants 496 adults with HTN and/or DM.Main out...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e059949.full |
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| author | Robert Kalyesubula Isaac Ssinabulya Rachel Nugent Christine Ngaruiya Nicola L Hawley Dallas Wood Baylah Tessier-Sherman Deron Galusha Mari Armstrong-Hough Sarah EG Moor Andrew K Tusubira Ann R Akiteng Evelyn Hsieh Donroe Tracy L Rabin Brenda D Nakirya Christine Nalwadda Jeremy I Schwartz |
| author_facet | Robert Kalyesubula Isaac Ssinabulya Rachel Nugent Christine Ngaruiya Nicola L Hawley Dallas Wood Baylah Tessier-Sherman Deron Galusha Mari Armstrong-Hough Sarah EG Moor Andrew K Tusubira Ann R Akiteng Evelyn Hsieh Donroe Tracy L Rabin Brenda D Nakirya Christine Nalwadda Jeremy I Schwartz |
| author_sort | Robert Kalyesubula |
| collection | DOAJ |
| description | Objective To explore how respondents with common chronic conditions—hypertension (HTN) and diabetes mellitus (DM)—make healthcare-seeking decisions.Setting Three health facilities in Nakaseke District, Uganda.Design Discrete choice experiment (DCE).Participants 496 adults with HTN and/or DM.Main outcome measures Willingness to pay for changes in DCE attributes: getting to the facility, interactions with healthcare providers, availability of medicines for condition, patient peer-support groups; and education at the facility.Results Respondents were willing to pay more to attend facilities that offer peer-support groups, friendly healthcare providers with low staff turnover and greater availabilities of medicines. Specifically, we found the average respondent was willing to pay an additional 77 121 Ugandan shillings (UGX) for facilities with peer-support groups over facilities with none; and 49 282 UGX for 1 month of medicine over none, all other things being equal. However, respondents would have to compensated to accept facilities that were further away or offered health education. Specifically, the average respondent would have to be paid 3929 UGX to be willing to accept each additional kilometre they would have to travel to the facilities, all other things being equal. Similarly, the average respondent would have to be paid 60 402 UGX to accept facilities with some health education, all other things being equal.Conclusions Our findings revealed significant preferences for health facilities based on the availability of medicines, costs of treatment and interactions with healthcare providers. Understanding patient preferences can inform intervention design to optimise healthcare service delivery for patients with HTN and DM in rural Uganda and other low-resource settings. |
| format | Article |
| id | doaj-art-29e1dabb63d648858a955b8b1d47d2e5 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-29e1dabb63d648858a955b8b1d47d2e52025-01-31T01:50:09ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-059949Patient preferences for facility-based management of hypertension and diabetes in rural Uganda: a discrete choice experimentRobert Kalyesubula0Isaac Ssinabulya1Rachel Nugent2Christine Ngaruiya3Nicola L Hawley4Dallas Wood5Baylah Tessier-Sherman6Deron Galusha7Mari Armstrong-Hough8Sarah EG Moor9Andrew K Tusubira10Ann R Akiteng11Evelyn Hsieh Donroe12Tracy L Rabin13Brenda D Nakirya14Christine Nalwadda15Jeremy I Schwartz16Departments of Physiology and Medicine, Makerere University College of Health Sciences, Kampala, UgandaUganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, UgandaGlobal Non-Communicable Diseases, RTI International, Seattle, Washington, USAYale Network for Global Non-communicable Diseases, Yale University, New Haven, Connecticut, USADepartment of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USACenter for Applied Economics and Strategy, RTI International, Research Triangle Park, North Carolina, USAEquity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, USAEquity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, USADepartment of Social and Behavioral Sciences and Department of Epidemiology, School of Global Public Health, New York University, New York, New York, USAYale School of Medicine, New Haven, Connecticut, USAUganda Initiative for Integrated Management of Non-communicable Diseases, Kampala, UgandaUganda Initiative for Integrated Management of Non-communicable Diseases, Kampala, UgandaDepartment of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USAUganda Initiative for Integrated Management of Non-communicable Diseases, Kampala, UgandaCommunity Concerns Uganda Initiative, Jinja, UgandaDepartment of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, UgandaUganda Initiative for Integrated Management of Non-communicable Diseases, Kampala, UgandaObjective To explore how respondents with common chronic conditions—hypertension (HTN) and diabetes mellitus (DM)—make healthcare-seeking decisions.Setting Three health facilities in Nakaseke District, Uganda.Design Discrete choice experiment (DCE).Participants 496 adults with HTN and/or DM.Main outcome measures Willingness to pay for changes in DCE attributes: getting to the facility, interactions with healthcare providers, availability of medicines for condition, patient peer-support groups; and education at the facility.Results Respondents were willing to pay more to attend facilities that offer peer-support groups, friendly healthcare providers with low staff turnover and greater availabilities of medicines. Specifically, we found the average respondent was willing to pay an additional 77 121 Ugandan shillings (UGX) for facilities with peer-support groups over facilities with none; and 49 282 UGX for 1 month of medicine over none, all other things being equal. However, respondents would have to compensated to accept facilities that were further away or offered health education. Specifically, the average respondent would have to be paid 3929 UGX to be willing to accept each additional kilometre they would have to travel to the facilities, all other things being equal. Similarly, the average respondent would have to be paid 60 402 UGX to accept facilities with some health education, all other things being equal.Conclusions Our findings revealed significant preferences for health facilities based on the availability of medicines, costs of treatment and interactions with healthcare providers. Understanding patient preferences can inform intervention design to optimise healthcare service delivery for patients with HTN and DM in rural Uganda and other low-resource settings.https://bmjopen.bmj.com/content/12/7/e059949.full |
| spellingShingle | Robert Kalyesubula Isaac Ssinabulya Rachel Nugent Christine Ngaruiya Nicola L Hawley Dallas Wood Baylah Tessier-Sherman Deron Galusha Mari Armstrong-Hough Sarah EG Moor Andrew K Tusubira Ann R Akiteng Evelyn Hsieh Donroe Tracy L Rabin Brenda D Nakirya Christine Nalwadda Jeremy I Schwartz Patient preferences for facility-based management of hypertension and diabetes in rural Uganda: a discrete choice experiment BMJ Open |
| title | Patient preferences for facility-based management of hypertension and diabetes in rural Uganda: a discrete choice experiment |
| title_full | Patient preferences for facility-based management of hypertension and diabetes in rural Uganda: a discrete choice experiment |
| title_fullStr | Patient preferences for facility-based management of hypertension and diabetes in rural Uganda: a discrete choice experiment |
| title_full_unstemmed | Patient preferences for facility-based management of hypertension and diabetes in rural Uganda: a discrete choice experiment |
| title_short | Patient preferences for facility-based management of hypertension and diabetes in rural Uganda: a discrete choice experiment |
| title_sort | patient preferences for facility based management of hypertension and diabetes in rural uganda a discrete choice experiment |
| url | https://bmjopen.bmj.com/content/12/7/e059949.full |
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