Preferences of older patients regarding hip fracture rehabilitation service configuration: A feasibility discrete choice experiment
Joanna M. Charles, Jessica L. Roberts, Nafees Ud Din, Nefyn H. Williams, Seow Tien Yeo, Rhiannon T. Edwards
Centre for Health Economics and Medicines Evaluation, Bangor University, LL57 2PZ Bangor, United Kingdom. E-mail: firstname.lastname@example.org
Objective: As part of a wider feasibility study, the feasibility of gaining older patients’ views for hip fracture rehabilitation services was tested using a discrete choice experiment in a UK context.
Design: Discrete choice experiment is a method used for eliciting individuals’ preferences about goods and services.
Subjects/patients: The discrete choice experiment was administered to 41 participants who had experienced hip fracture (mean age 79.3 years; standard deviation (SD) 7.5 years), recruited from a larger feasibility study exploring a new multidisciplinary rehabilitation for hip fracture.
Methods: Attributes and levels for this discrete choice experiment were identified from a systematic review and focus groups. The questionnaire was administered at the 3-month follow-up.
Results: Participants indicated a significant preference for a fully-qualified physiotherapist or occupational therapist to deliver the rehabilitation sessions (β = 0·605, 95% confidence interval (95% CI) 0.462–0.879), and for their rehabilitation session to last less than 90 min (β = –0.192, 95% CI –0.381 to –0.051).
Conclusion: The design of the discrete choice experiment using attributes associated with service configuration could have the potential to inform service implementation, and assist rehabilitation service design that incorporates the preferences of patients.
In this study, older patients who recently experienced hip fracture were asked to state their preferences about hip fracture services. A method used specifically for eliciting preferences, the discrete choice experiment, was used. Using a questionnaire, hypothetical services were presented to patients 3 months after their hip fracture, asking them to state which service they preferred. Older patients stated preferences for a fully-qualified physiotherapist or occupational therapist to deliver the rehabilitation sessions, and for their rehabilitation session to last less than 90 min. By asking about service structure (for example, where rehabilitation takes place and who will deliver the rehabilitation), a preferred package of rehabilitation could be offered to patients in future, aiding their recovery.
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