Abstract
Purpose :
Eliciting patient perspectives can help inform in the design and improvement of an ophthalmology service to provide care that is respectful of and responsive to individual patient preferences, needs, and values. A discrete choice experiment is a survey technique where scenarios are presented for respondents to make trade-offs between two attributes by weighing the relative importance of each.
Methods :
This study evaluated patient preferences at two academic ophthalmology clinics in Seattle, Washington. A discrete choice experiment was used to evaluate the relative importance of the following variables: out-of-pocket costs, expertise, wait times, appointment numbers, face-to-face times, and continuity of care. Forty-three patients were recruited from two ophthalmology clinics. Demographic data was collected. Patients were asked to rank the importance of each variable for their care. Additionally, eight choice-tasks were presented in random order and forced-choice preferences were elicited. The survey was translated into Spanish by the Harborview Interpreter Services, and telephonic or in-person interpreters were used when necessary. Ranked data was visualized. Choice data were analyzed using a binomial sign test.
Results :
The relative importance of one attribute to another was measured first via a self-rank of attributes and second a discrete-choice questionnaire. Patients showed a wide variety of preferences across the different attributes. A self-ranking of attributes revealed high preferences for improved continuity of care, increased physician experience and increased face to face time. Discrete choice testing revealed that patients strongly preferred continuity of care (P<0.05). Face to face time was also the least preferred option when in conflict with other attributes (P<0.05).
Conclusions :
Self-ranking and discrete-choice questionnaire matched in their evaluation of patient preferences for most attributes in terms of relative importance. In the latter, continuity of care was the most important attribute. Patients over-estimated the importance of face-to-face time with the provider when compared with a discrete-choice questionnaire evaluation. One limitation of this study was the small sample size. Future work with a larger study population could provide additional insight into attributes important for patient-centered care and help guide improvements to how care is delivered.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.