Preferences for centralised emergency medical services: discrete choice experiment
Objectives It is desirable that public preferences are established and incorporated in emergency healthcare reforms. The aim of this study was to investigate preferences for local versus centralised provision of all emergency medical services (EMS) and explore what individuals think are important co...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2019-11-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/11/e030966.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846150381464190976 |
|---|---|
| author | Luke Vale Peter McMeekin Nawaraj Bhattarai Christopher I Price |
| author_facet | Luke Vale Peter McMeekin Nawaraj Bhattarai Christopher I Price |
| author_sort | Luke Vale |
| collection | DOAJ |
| description | Objectives It is desirable that public preferences are established and incorporated in emergency healthcare reforms. The aim of this study was to investigate preferences for local versus centralised provision of all emergency medical services (EMS) and explore what individuals think are important considerations for EMS delivery.Design A discrete choice experiment was conducted. The attributes used in the choice scenarios were: travel time to the hospital, waiting time to be seen, length of stay in the hospital, risks of dying, readmission and opportunity for outpatient care after emergency treatment at a local hospital.Setting North East England.Participants Participants were a randomly sampled general population, aged 16 years or above recruited from Healthwatch Northumberland network database of lay members and from clinical contact with Northumbria Healthcare National Health Service Foundation Trust via Patient Experience Team.Primary and secondary outcome measures Analysis used logistic regression modelling techniques to determine the preference of each attribute. Marginal rates of substitution between attributes were estimated to understand the trade-offs individuals were willing to make.Results Responses were obtained from 148 people (62 completed a web and 86 a postal version). Respondents preferred shorter travel time to hospital, shorter waiting time, fewer number of days in hospital, low risk of death, low risk of readmission and outpatient follow-up care in their local hospital. However, individuals were willing to trade off increased travel time and waiting time for high-quality centralised care. Individuals were willing to travel 9 min more for a 1-day reduction in length of stay in the hospital, 38 min for a 1% reduction in risk of death and 112 min for having outpatient follow-up care at their local hospital.Conclusions People value centralised EMS if it provides higher quality care and are willing to travel further and wait longer. |
| format | Article |
| id | doaj-art-3b12e84306dc40bfa7666de638cbc6b6 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-3b12e84306dc40bfa7666de638cbc6b62024-11-28T23:40:12ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-030966Preferences for centralised emergency medical services: discrete choice experimentLuke Vale0Peter McMeekin1Nawaraj Bhattarai2Christopher I Price34 Newcastle University, Newcastle upon Tyne, UK2 Faculty of Health and Life Sciences, University of Northumbria at Newcastle, Newcastle upon Tyne, UKHealth Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK1Stroke Research Group, Population Health Sciences Institute, Newcastle University, UKObjectives It is desirable that public preferences are established and incorporated in emergency healthcare reforms. The aim of this study was to investigate preferences for local versus centralised provision of all emergency medical services (EMS) and explore what individuals think are important considerations for EMS delivery.Design A discrete choice experiment was conducted. The attributes used in the choice scenarios were: travel time to the hospital, waiting time to be seen, length of stay in the hospital, risks of dying, readmission and opportunity for outpatient care after emergency treatment at a local hospital.Setting North East England.Participants Participants were a randomly sampled general population, aged 16 years or above recruited from Healthwatch Northumberland network database of lay members and from clinical contact with Northumbria Healthcare National Health Service Foundation Trust via Patient Experience Team.Primary and secondary outcome measures Analysis used logistic regression modelling techniques to determine the preference of each attribute. Marginal rates of substitution between attributes were estimated to understand the trade-offs individuals were willing to make.Results Responses were obtained from 148 people (62 completed a web and 86 a postal version). Respondents preferred shorter travel time to hospital, shorter waiting time, fewer number of days in hospital, low risk of death, low risk of readmission and outpatient follow-up care in their local hospital. However, individuals were willing to trade off increased travel time and waiting time for high-quality centralised care. Individuals were willing to travel 9 min more for a 1-day reduction in length of stay in the hospital, 38 min for a 1% reduction in risk of death and 112 min for having outpatient follow-up care at their local hospital.Conclusions People value centralised EMS if it provides higher quality care and are willing to travel further and wait longer.https://bmjopen.bmj.com/content/9/11/e030966.full |
| spellingShingle | Luke Vale Peter McMeekin Nawaraj Bhattarai Christopher I Price Preferences for centralised emergency medical services: discrete choice experiment BMJ Open |
| title | Preferences for centralised emergency medical services: discrete choice experiment |
| title_full | Preferences for centralised emergency medical services: discrete choice experiment |
| title_fullStr | Preferences for centralised emergency medical services: discrete choice experiment |
| title_full_unstemmed | Preferences for centralised emergency medical services: discrete choice experiment |
| title_short | Preferences for centralised emergency medical services: discrete choice experiment |
| title_sort | preferences for centralised emergency medical services discrete choice experiment |
| url | https://bmjopen.bmj.com/content/9/11/e030966.full |
| work_keys_str_mv | AT lukevale preferencesforcentralisedemergencymedicalservicesdiscretechoiceexperiment AT petermcmeekin preferencesforcentralisedemergencymedicalservicesdiscretechoiceexperiment AT nawarajbhattarai preferencesforcentralisedemergencymedicalservicesdiscretechoiceexperiment AT christopheriprice preferencesforcentralisedemergencymedicalservicesdiscretechoiceexperiment |