Discrete choice experiment on educating value-based healthcare

Abstract

IntroductionIdentifying costs and values in healthcare interventions as well as the ability to measure and consider costs relative to value for patients are pivotal in clinical decision-making and medical education. This study explores residents’ preferences in educating value-based healthcare (VBHC) during postgraduate medical education. Exploring residents’ preferences in VBHC education, in order to understand what shapes their choices, might contribute to improved medical residency education and healthcare as a whole.MethodsA discrete choice experiment (DCE) examined which conditions for educating VBHC are preferred by residents. DCE gives more insight into the trade-off’s residents make when choosing alternatives, and which conditions for educating VBHC have the most influence on residents’ preference.ResultsThis DCE shows that residents prefer knowledge on both medical practice as well as the process of care—to be educated by an expert on VBHC together with a clinician. They prefer limited protected time to conduct VBHC initiatives (thus while at work) and desire the inclusion of VBHC in formal educational plans.ConclusionWhen optimising graduate and postgraduate medical education curricula, these preferences should be considered to create necessary conditions for the facilitation and participation of residents in VBHC education and the set-up of VBHC initiatives.

Evaluating Patient and Provider Preferences for a Once-Weekly Basal Insulin in Adults with Type 2 Diabetes

“…The surveys consisted of two parts: 1) a variety of yes/no, multiple-choice, and Likert-scale questions on a seven-point scale (where one was strongly disagree / extremely unsatisfied / restrictive / not at all influential and seven was strongly agree / extremely satisfied / convenient / extremely influential) or an 11-point scale (where zero was not at all likely and ten was extremely likely); and 2) a discrete choice exercise (DCE), a research technique used to elicit preferences based on hypothetical choice sets. 25 In the DCE, patients selected which basal insulin they would most prefer to use to self-manage their T2D. Patients were instructed to assume the following as they made their decisions in the DCE: a) “you can afford all medication options”, b) “the cost to you is the same for all medications”, c) “all medications are available at your preferred pharmacy”, d) “all medications have been approved for use in patients with type 2 diabetes by the FDA”, and e) “all medications have been approved by your doctor.” HCPs indicated how many of their next ten patients with T2D (who were eligible for basal insulin) they would recommend/prescribe for each medication shown.…”

What do Turkish, Spanish, and Pakistani medical students value in specialty training positions? A discrete choice experiment

“…They were, however, limited to the UK and China. Apart from the mentioned studies, a study from the Netherlands [ 10 ] has used DCE to determine the preferences of residents on value-based healthcare education. To our knowledge, there is no DCE study that was conducted outside of the UK and China to understand senior medical students’ career preferences.…”