Int J Med Inform - Physician and patient willingness to pay for electronic cardiovascular disease management.

Tópicos

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Resumo

JECTIVES: Cardiovascular disease (CVD) is an important target for electronic decision support. We examined the potential sustainability of an electronic CVD management program using a discrete choice experiment (DCE). Our objective was to estimate physician and patient willingness-to-pay (WTP) for the current and enhanced programs.METHODS: Focus groups, expert input and literature searches decided the attributes to be evaluated for the physician and patient DCEs, which were carried out using a Web-based program. Hierarchical Bayes analysis estimated preference coefficients for each respondent and latent class analysis segmented each sample. Simulations were used to estimate WTP for each of the attributes individually and for an enhanced vascular management system.RESULTS: 144 participants (70 physicians, 74 patients) completed the DCE. Overall, access speed to updated records and monthly payments for a nurse coordinator were the main determinants of physician choices. Two distinctly different segments of physicians were identified - one very sensitive to monthly subscription fee and speed of updating the tracker with new patient data and the other very sensitive to the monthly cost of the nurse coordinator and government billing incentives. Patient choices were most significantly influenced by the yearly subscription cost. The estimated physician WTP was slightly above the estimated threshold for sustainability while the patient WTP was below.CONCLUSION: Current willingness to pay for electronic cardiovascular disease management should encourage innovation to provide economies of scale in program development, delivery and maintenance to meet sustainability thresholds.

Resumo Limpo

jectiv cardiovascular diseas cvd import target electron decis support examin potenti sustain electron cvd manag program use discret choic experi dce object estim physician patient willingnesstopay wtp current enhanc programsmethod focus group expert input literatur search decid attribut evalu physician patient dces carri use webbas program hierarch bay analysi estim prefer coeffici respond latent class analysi segment sampl simul use estim wtp attribut individu enhanc vascular manag systemresult particip physician patient complet dce overal access speed updat record month payment nurs coordin main determin physician choic two distinct differ segment physician identifi one sensit month subscript fee speed updat tracker new patient data sensit month cost nurs coordin govern bill incent patient choic signific influenc year subscript cost estim physician wtp slight estim threshold sustain patient wtp belowconclus current willing pay electron cardiovascular diseas manag encourag innov provid economi scale program develop deliveri mainten meet sustain threshold

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