Establishing patient preferences for gastroenterology clinic reorganization using conjoint analysis.
OBJECTIVE
The Department of Health states that patients with suspected cancer should be seen within 2 weeks, and the Patients' Charter suggests that patients should not wait for more than 30 min in outpatients. Decisions such as these are often made with little assessment of patient preferences. We have elicited patient preferences for the optimal use of time in the outpatient clinic.


METHODS
Questionnaire survey eliciting preference between different clinic scenarios evaluated using discrete choice conjoint analysis.


METHODS
Patients attending a teaching hospital gastroenterology outpatient clinic.


METHODS
The relative importance of time spent on the waiting list, time waiting in the clinic, time spent with the specialist, and time waiting for investigation was assessed using a logit model.


RESULTS
Patients placed a similar value on waiting for investigation and time spent on the waiting list. A clinic that had a 2-month waiting list but offered immediate investigations would therefore be more popular than a clinic that had a 2-week waiting list but whose investigations were deferred for 3 months. Patients would be prepared to spend an extra 30 min in the waiting room if they spent 1 month less on the waiting list or waiting for investigation. Time spent with a specialist is valued, and patients would be prepared to spend an extra 3 min waiting in the clinic for every extra minute spent with the doctor.


CONCLUSIONS
The present Department of Health recommendations and the Patients' Charter are too simplistic and do not take into account patient preferences.
Moayyedi
Paul
P
Gastroenterology Health Services Research, City Hospital NHS Trust, Dudley Road, Winson Green, Birmingham B18 7QH, UK. p.moayyedi@bham.ac.uk
Wardman
Mark
M
Toner
Jeremy
J
Ryan
Mandy
M
Duffett
Sara
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D005260:Female; D005762:Gastroenterology / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008389:Marketing of Health Services; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D017748:Time Management; D006113:United Kingdom; D014850:Waiting Lists