title: Preferences of Bulgarian consumers for quality, access and price attributes of healthcare services-result of a discrete choice experiment.
abstract: OBJECTIVE
  The aim of the study is to determine the preferences of Bulgarian citizens regarding the provision of healthcare services.
  
  
  METHODS
  A survey was carried out in Bulgaria among a nationally representative sample of 1003 respondents. Both a discrete choice experiment and a self-explicated ranking of outpatient and inpatient service attributes were included in the survey. The data are analyzed to elicit the preferences of Bulgarian healthcare consumers for service attributes and to compare them with previous studies in Bulgaria and other countries in Central and Eastern Europe.
  
  
  RESULTS
  The reputation and skills of the care provider appear to be relatively most important to the respondents, followed by the state of the equipment, the condition of the facility and the attitude of the staff. The fee-level and access-related attributes (waiting and traveling time) emerged as less important. Overall, consumers in Bulgaria value the quality of healthcare provision very highly. Yet, there are some statistically significant differences between socio-demographic groups.
  
  
  CONCLUSIONS
  In general, Bulgarian healthcare consumers are willing to accept higher prices for the services they use, when this comes with improved quality of services. These findings comply with findings in previous studies in Bulgaria and in the region. Given the quality problems in the Bulgarian healthcare sector, our findings indicate that priority has to be given to the improvement of healthcare quality when the Bulgarian government invests in this sector. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands.
authors.forename: Thijs
authors.initials: T
authors.lastname: van de Schoot
authors.affiliation: Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands.
authors.forename: Milena
authors.initials: M
authors.lastname: Pavlova
authors.affiliation: Department of Health Economics and Management, Faculty of Public Health, Medical University-Varna, Varna, Bulgaria.
authors.forename: Elka
authors.initials: E
authors.lastname: Atanasova
authors.affiliation: Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Groot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002031:Bulgaria; D002755:Choice Behavior; D003258:Consumer Behavior; D005260:Female; D019538:Health Care Surveys; D006296:Health Services / Q000191:economics*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Bulgaria; discrete choice experiment; healthcare; patient preferences