Patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the Which? trial.

<h4>Background</h4>Beyond examining their overall cost-effectiveness and mechanisms of effect, it is important to understand patient preferences for the delivery of different modes of chronic heart failure management programs (CHF-MPs). We elicited patient preferences around the characte...

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Autores principales:	Jennifer A Whitty, Simon Stewart, Melinda J Carrington, Alicia Calderone, Thomas Marwick, John D Horowitz, Henry Krum, Patricia M Davidson, Peter S Macdonald, Christopher Reid, Paul A Scuffham
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f313bde2271a4909aeb6eb8295219d7b
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spelling	oai:doaj.org-article:f313bde2271a4909aeb6eb8295219d7b2021-11-18T07:54:22ZPatient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the Which? trial.1932-620310.1371/journal.pone.0058347https://doaj.org/article/f313bde2271a4909aeb6eb8295219d7b2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23505491/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Beyond examining their overall cost-effectiveness and mechanisms of effect, it is important to understand patient preferences for the delivery of different modes of chronic heart failure management programs (CHF-MPs). We elicited patient preferences around the characteristics and willingness-to-pay (WTP) for a clinic or home-based CHF-MP.<h4>Methodology/principal findings</h4>A Discrete Choice Experiment was completed by a sub-set of patients (n = 91) enrolled in the WHICH? trial comparing home versus clinic-based CHF-MP. Participants provided 5 choices between hypothetical clinic and home-based programs varying by frequency of nurse consultations, nurse continuity, patient costs, and availability of telephone or education support. Participants (aged 71±13 yrs, 72.5% male, 25.3% NYHA class III/IV) displayed two distinct preference classes. A latent class model of the choice data indicated 56% of participants preferred clinic delivery, access to group CHF education classes, and lower cost programs (p<0.05). The remainder preferred home-based CHF-MPs, monthly rather than weekly visits, and access to a phone advice service (p<0.05). Continuity of nurse contact was consistently important. No significant association was observed between program preference and participant allocation in the parent trial. WTP was estimated from the model and a dichotomous bidding technique. For those preferring clinic, estimated WTP was ≈AU$9-20 per visit; however for those preferring home-based programs, WTP varied widely (AU$15-105).<h4>Conclusions/significance</h4>Patient preferences for CHF-MPs were dichotomised between a home-based model which is more likely to suit older patients, those who live alone, and those with a lower household income; and a clinic-based model which is more likely to suit those who are more socially active and wealthier. To optimise the delivery of CHF-MPs, health care services should consider their patients' preferences when designing CHF-MPs.Jennifer A WhittySimon StewartMelinda J CarringtonAlicia CalderoneThomas MarwickJohn D HorowitzHenry KrumPatricia M DavidsonPeter S MacdonaldChristopher ReidPaul A ScuffhamPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e58347 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jennifer A Whitty Simon Stewart Melinda J Carrington Alicia Calderone Thomas Marwick John D Horowitz Henry Krum Patricia M Davidson Peter S Macdonald Christopher Reid Paul A Scuffham Patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the Which? trial.
description	<h4>Background</h4>Beyond examining their overall cost-effectiveness and mechanisms of effect, it is important to understand patient preferences for the delivery of different modes of chronic heart failure management programs (CHF-MPs). We elicited patient preferences around the characteristics and willingness-to-pay (WTP) for a clinic or home-based CHF-MP.<h4>Methodology/principal findings</h4>A Discrete Choice Experiment was completed by a sub-set of patients (n = 91) enrolled in the WHICH? trial comparing home versus clinic-based CHF-MP. Participants provided 5 choices between hypothetical clinic and home-based programs varying by frequency of nurse consultations, nurse continuity, patient costs, and availability of telephone or education support. Participants (aged 71±13 yrs, 72.5% male, 25.3% NYHA class III/IV) displayed two distinct preference classes. A latent class model of the choice data indicated 56% of participants preferred clinic delivery, access to group CHF education classes, and lower cost programs (p<0.05). The remainder preferred home-based CHF-MPs, monthly rather than weekly visits, and access to a phone advice service (p<0.05). Continuity of nurse contact was consistently important. No significant association was observed between program preference and participant allocation in the parent trial. WTP was estimated from the model and a dichotomous bidding technique. For those preferring clinic, estimated WTP was ≈AU$9-20 per visit; however for those preferring home-based programs, WTP varied widely (AU$15-105).<h4>Conclusions/significance</h4>Patient preferences for CHF-MPs were dichotomised between a home-based model which is more likely to suit older patients, those who live alone, and those with a lower household income; and a clinic-based model which is more likely to suit those who are more socially active and wealthier. To optimise the delivery of CHF-MPs, health care services should consider their patients' preferences when designing CHF-MPs.
format	article
author	Jennifer A Whitty Simon Stewart Melinda J Carrington Alicia Calderone Thomas Marwick John D Horowitz Henry Krum Patricia M Davidson Peter S Macdonald Christopher Reid Paul A Scuffham
author_facet	Jennifer A Whitty Simon Stewart Melinda J Carrington Alicia Calderone Thomas Marwick John D Horowitz Henry Krum Patricia M Davidson Peter S Macdonald Christopher Reid Paul A Scuffham
author_sort	Jennifer A Whitty
title	Patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the Which? trial.
title_short	Patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the Which? trial.
title_full	Patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the Which? trial.
title_fullStr	Patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the Which? trial.
title_full_unstemmed	Patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the Which? trial.
title_sort	patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the which? trial.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/f313bde2271a4909aeb6eb8295219d7b
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Patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the Which? trial.

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