Patient Preferences and Willingness-To-Pay for a Home or Clinic Based Program of Chronic Heart Failure Management: Findings from the Which? Trial
Background: 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 willing...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal Article |
| Published: |
2013
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| Online Access: | http://hdl.handle.net/20.500.11937/19895 |
| _version_ | 1848750159231451136 |
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| author | Whitty, J. Stewart, S. Carrington, M. Calderone, A. Marwick, T. Horowitz, J. Krum, H. Davidson, P. Macdonald, P. Reid, Christopher Scuffham, P. |
| author_facet | Whitty, J. Stewart, S. Carrington, M. Calderone, A. Marwick, T. Horowitz, J. Krum, H. Davidson, P. Macdonald, P. Reid, Christopher Scuffham, P. |
| author_sort | Whitty, J. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: 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. Methodology/Principal Findings: 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). Conclusions/Significance: 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. © 2013 Whitty et al. |
| first_indexed | 2025-11-14T07:32:24Z |
| format | Journal Article |
| id | curtin-20.500.11937-19895 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:32:24Z |
| publishDate | 2013 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-198952017-09-13T13:50:23Z Patient Preferences and Willingness-To-Pay for a Home or Clinic Based Program of Chronic Heart Failure Management: Findings from the Which? Trial Whitty, J. Stewart, S. Carrington, M. Calderone, A. Marwick, T. Horowitz, J. Krum, H. Davidson, P. Macdonald, P. Reid, Christopher Scuffham, P. Background: 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. Methodology/Principal Findings: 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). Conclusions/Significance: 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. © 2013 Whitty et al. 2013 Journal Article http://hdl.handle.net/20.500.11937/19895 10.1371/journal.pone.0058347 unknown |
| spellingShingle | Whitty, J. Stewart, S. Carrington, M. Calderone, A. Marwick, T. Horowitz, J. Krum, H. Davidson, P. Macdonald, P. Reid, Christopher Scuffham, P. Patient Preferences and Willingness-To-Pay for a Home or Clinic Based Program of Chronic Heart Failure Management: Findings from the Which? Trial |
| 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_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_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_sort | patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the which? trial |
| url | http://hdl.handle.net/20.500.11937/19895 |