Patient preferences for use of virtual consultations in an orthopaedic rehabilitation setting: results from a discrete choice experiment
Patient preferences for use of virtual consultations in an orthopaedic rehabilitation setting: results from a discrete choice experiment
Objective: virtual consultations may reduce the need for face-to-face outpatient appointments, thereby potentially reducing the cost and time involved in delivering health care. This study reports a discrete choice experiment (DCE) that identifies factors that influence patient preferences for virtual consultations in an orthopaedic rehabilitation setting.
Methods: previous research from the CONNECT (Care in Orthopaedics, burden of treatment and the Effect of Communication Technology) Project and best practice guidance informed the development of our DCE. An efficient fractional factorial design with 16 choice scenarios was created that identified all main effects and partial two-way interactions. The design was divided into two blocks of eight scenarios each, to reduce the impact of cognitive fatigue. Data analysis were conducted using binary logit regression models.
Results: sixty-one paired response sets (122 subjects) were available for analysis. DCE factors (whether the therapist is known to the patient, duration of appointment, time of day) and demographic factors (patient qualifications, access to equipment, difficulty with activities, multiple health issues, travel costs) were significant predictors of preference. We estimate that a patient is less than 1% likely to prefer a virtual consultation if the patient has a degree, is without access to the equipment and software to undertake a virtual consultation, does not have difficulties with day-to-day activities, is undergoing rehabilitation for one problem area, has to pay less than £5 to travel, is having a consultation with a therapist not known to them, in 1 weeks’ time, lasting 60 minutes, at 2 pm. We have developed a simple conceptual model to explain how these factors interact to inform preference, including patients’ access to resources, context for the consultation and the requirements of the consultation.
Conclusions: this conceptual model provides the framework to focus attention towards factors that might influence patient preference for virtual consultations. Our model can inform the development of future technologies, trials, and qualitative work to further explore the mechanisms that influence preference.
Virtual consultation, discrete choice experiment, orthopaedics
Gilbert, Anthony W
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Mentzakis, Emmanouil
c0922185-18c7-49c2-a659-8ee6d89b5d74
May, Carl R
8545251b-ec62-4182-94d1-71570baebeba
Stokes, Maria
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Jones, Jeremy
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1 August 2021
Gilbert, Anthony W
a450c811-c6d3-4853-ae35-9f5287db8efa
Mentzakis, Emmanouil
c0922185-18c7-49c2-a659-8ee6d89b5d74
May, Carl R
8545251b-ec62-4182-94d1-71570baebeba
Stokes, Maria
71730503-70ce-4e67-b7ea-a3e54579717f
Jones, Jeremy
270b303b-6bad-4be7-8ea0-63d0e8015c91
Gilbert, Anthony W, Mentzakis, Emmanouil, May, Carl R, Stokes, Maria and Jones, Jeremy
(2021)
Patient preferences for use of virtual consultations in an orthopaedic rehabilitation setting: results from a discrete choice experiment.
Journal of Health Services Research & Policy.
(doi:10.1177/13558196211035427).
Abstract
Objective: virtual consultations may reduce the need for face-to-face outpatient appointments, thereby potentially reducing the cost and time involved in delivering health care. This study reports a discrete choice experiment (DCE) that identifies factors that influence patient preferences for virtual consultations in an orthopaedic rehabilitation setting.
Methods: previous research from the CONNECT (Care in Orthopaedics, burden of treatment and the Effect of Communication Technology) Project and best practice guidance informed the development of our DCE. An efficient fractional factorial design with 16 choice scenarios was created that identified all main effects and partial two-way interactions. The design was divided into two blocks of eight scenarios each, to reduce the impact of cognitive fatigue. Data analysis were conducted using binary logit regression models.
Results: sixty-one paired response sets (122 subjects) were available for analysis. DCE factors (whether the therapist is known to the patient, duration of appointment, time of day) and demographic factors (patient qualifications, access to equipment, difficulty with activities, multiple health issues, travel costs) were significant predictors of preference. We estimate that a patient is less than 1% likely to prefer a virtual consultation if the patient has a degree, is without access to the equipment and software to undertake a virtual consultation, does not have difficulties with day-to-day activities, is undergoing rehabilitation for one problem area, has to pay less than £5 to travel, is having a consultation with a therapist not known to them, in 1 weeks’ time, lasting 60 minutes, at 2 pm. We have developed a simple conceptual model to explain how these factors interact to inform preference, including patients’ access to resources, context for the consultation and the requirements of the consultation.
Conclusions: this conceptual model provides the framework to focus attention towards factors that might influence patient preference for virtual consultations. Our model can inform the development of future technologies, trials, and qualitative work to further explore the mechanisms that influence preference.
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13558196211035427
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Accepted/In Press date: 8 July 2021
e-pub ahead of print date: 1 August 2021
Published date: 1 August 2021
Additional Information:
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Anthony Gilbert, Clinical Doctoral Research Fellow (ICA-CDRF-2017–03-025) is funded by Health Education England and the National Institute for Health Research (NIHR). Anthony Gilbert and Carl May are supported by the National Institute for Health Research ARC North Thames. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
Publisher Copyright:
© The Author(s) 2021.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
Virtual consultation, discrete choice experiment, orthopaedics
Identifiers
Local EPrints ID: 453498
URI: http://eprints.soton.ac.uk/id/eprint/453498
ISSN: 1355-8196
PURE UUID: b1ed6262-c367-4b21-891e-56a917373943
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Date deposited: 18 Jan 2022 17:53
Last modified: 17 Mar 2024 03:28
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Author:
Anthony W Gilbert
Author:
Carl R May
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