Patients’ preferences for health insurance coverage of new technologies for treating chronic diseases in China: a discrete choice experiment
Objectives Our study aimed to inform insurance decision-making in China by investigating patients’ preferences for insurance coverage of new technologies for treating chronic diseases.Design We identified six attributes of new medical technologies for treating chronic diseases and used Bayesian-effi...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e038051.full |
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| author | Jinsong Geng Xiaowei Chen Haini Bao Danmin Qian Yuting Shao Hao Yu |
| author_facet | Jinsong Geng Xiaowei Chen Haini Bao Danmin Qian Yuting Shao Hao Yu |
| author_sort | Jinsong Geng |
| collection | DOAJ |
| description | Objectives Our study aimed to inform insurance decision-making in China by investigating patients’ preferences for insurance coverage of new technologies for treating chronic diseases.Design We identified six attributes of new medical technologies for treating chronic diseases and used Bayesian-efficient design to generate choice sets for a discrete choice experiment (DCE). After conducting the DCE, we analysed the data by mixed logit regression to examine patient-reported preferences for each attribute.Setting The DCE was conducted with patients in six tertiary hospitals from four cities in Jiangsu province.Participants Patients aged 18 years or older with a history of diabetes or hypertension and taking medications regularly for more than 1 year were recruited (n=408).Results The technology attributes regarding expected gains in health outcomes from the treatment, high likelihood of effective treatment and low incidence of serious adverse events were significant, positive predictors of choice by the study patients (p<0.01). The out-of-pocket cost was a significant, negative attribute for the entire study sample (β = −0.258, p<0.01) and for the patients with Urban-Rural Residents Basic Medical Insurance (URRBMI) (β = −0.511, p<0.01), but not for all the patients with Urban Employees Basic Medical Insurance (UEBMI) (β = −0.071, p>0.05). The severity of target disease was valued by patients with lower EQ-5D-5L index value as well as URRBMI enrollees.Conclusions Patients highly valued the health benefits and risks of new technologies, which were closely linked to their feelings of disease and perceptions of health-related quality of life. However, there existed heterogeneity in preferences between URRBMI and UEBMI patients. Further efforts should be made to reduce the gap between insurance schemes and make safe and cost-effective new technologies as a priority for health insurance reimbursement. |
| format | Article |
| id | doaj-art-235da3a2097c44018e4e8aa00ca2d527 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-235da3a2097c44018e4e8aa00ca2d5272025-01-08T21:00:12ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-038051Patients’ preferences for health insurance coverage of new technologies for treating chronic diseases in China: a discrete choice experimentJinsong Geng0Xiaowei Chen1Haini Bao2Danmin Qian3Yuting Shao4Hao Yu5Department of Medical Informatics, Nantong University Medical School, Nantong, Jiangsu, ChinaDepartment of Spleen, Stomach, Liver and Gallbladder Diseases, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Medical Informatics, Nantong University Medical School, Nantong, Jiangsu, ChinaDepartment of Medical Informatics, Nantong University Medical School, Nantong, Jiangsu, ChinaDepartment of Ophthalmology, Tongji University School of Medicine, Shanghai, ChinaDepartment of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong Provincial Clinical Research Center for Urological Diseases, Guangzhou, Guangdong, P.R. ChinaObjectives Our study aimed to inform insurance decision-making in China by investigating patients’ preferences for insurance coverage of new technologies for treating chronic diseases.Design We identified six attributes of new medical technologies for treating chronic diseases and used Bayesian-efficient design to generate choice sets for a discrete choice experiment (DCE). After conducting the DCE, we analysed the data by mixed logit regression to examine patient-reported preferences for each attribute.Setting The DCE was conducted with patients in six tertiary hospitals from four cities in Jiangsu province.Participants Patients aged 18 years or older with a history of diabetes or hypertension and taking medications regularly for more than 1 year were recruited (n=408).Results The technology attributes regarding expected gains in health outcomes from the treatment, high likelihood of effective treatment and low incidence of serious adverse events were significant, positive predictors of choice by the study patients (p<0.01). The out-of-pocket cost was a significant, negative attribute for the entire study sample (β = −0.258, p<0.01) and for the patients with Urban-Rural Residents Basic Medical Insurance (URRBMI) (β = −0.511, p<0.01), but not for all the patients with Urban Employees Basic Medical Insurance (UEBMI) (β = −0.071, p>0.05). The severity of target disease was valued by patients with lower EQ-5D-5L index value as well as URRBMI enrollees.Conclusions Patients highly valued the health benefits and risks of new technologies, which were closely linked to their feelings of disease and perceptions of health-related quality of life. However, there existed heterogeneity in preferences between URRBMI and UEBMI patients. Further efforts should be made to reduce the gap between insurance schemes and make safe and cost-effective new technologies as a priority for health insurance reimbursement.https://bmjopen.bmj.com/content/10/9/e038051.full |
| spellingShingle | Jinsong Geng Xiaowei Chen Haini Bao Danmin Qian Yuting Shao Hao Yu Patients’ preferences for health insurance coverage of new technologies for treating chronic diseases in China: a discrete choice experiment BMJ Open |
| title | Patients’ preferences for health insurance coverage of new technologies for treating chronic diseases in China: a discrete choice experiment |
| title_full | Patients’ preferences for health insurance coverage of new technologies for treating chronic diseases in China: a discrete choice experiment |
| title_fullStr | Patients’ preferences for health insurance coverage of new technologies for treating chronic diseases in China: a discrete choice experiment |
| title_full_unstemmed | Patients’ preferences for health insurance coverage of new technologies for treating chronic diseases in China: a discrete choice experiment |
| title_short | Patients’ preferences for health insurance coverage of new technologies for treating chronic diseases in China: a discrete choice experiment |
| title_sort | patients preferences for health insurance coverage of new technologies for treating chronic diseases in china a discrete choice experiment |
| url | https://bmjopen.bmj.com/content/10/9/e038051.full |
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