Patients' preferences for healthcare system reforms in Hungary: a conjoint analysis.
OBJECTIVE
To illustrate how conjoint analysis can be used to identify patient preferences for healthcare policies, and to measure preferences for healthcare reforms in Hungary.


METHODS
Data was collected via a mail-based survey and a direct survey administered in a rheumatology out-patient centre in Flór Ferenc County Hospital, Budapest, Hungary (n = 86).


METHODS
We designed and administered a conjoint analysis to the study population. Attributes and attribute levels were developed on the basis of key informant interviews and a literature review. Additional demographic, occupation and healthcare utilisation data were also collected using surveys. A mixed effects linear probability model was estimated holding respondent characteristics constant and correcting for clustering.


METHODS
Conjoint analysis questionnaires were administered by a physician to 50 consecutive rheumatology patients in a clinic and an additional 36 were mailed by post.


RESULTS
The response rate for the physician-administered survey was 98% (but 18% of these were excluded for inconsistent preferences) and 53% for the mail survey, leaving a final sample of 59. Regression results (R2 = 56.8%) indicated that patients preferred a health system that was not cost constrained (p = 0.003), was based on solidarity (p < 0.001) and where patients were empowered (p = 0.024). Further, they would choose a system with no choice of provider to avoid co-payments (p = 0.005).


CONCLUSIONS
This study demonstrates that patients have clear preferences for healthcare system policy. In order to develop evidence-based healthcare policy and to empower patients in the healthcare system, methods such as conjoint analysis offer a simple yet theoretically grounded basis for policy making.
Akkazieva
Baktygul
B
Department of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg, Germany.
Gulacsi
Laszlo
L
Brandtmuller
Agnes
A
Péntek
Márta
M
Bridges
John F P
JF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003669:Deductibles and Coinsurance; D005062:European Union; D005260:Female; D017048:Health Care Costs; D018166:Health Care Reform / Q000191:economics / Q000379:methods*; D019538:Health Care Surveys / Q000379:methods; D006301:Health Services Needs and Demand / Q000191:economics; D006766:Hospitals, County; D006801:Humans; D006814:Hungary; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010358:Patient Participation / Q000191:economics; D017060:Patient Satisfaction / Q000191:economics / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000191:economics; D012044:Regression Analysis; D012219:Rheumatology; D011795:Surveys and Questionnaires