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Patient preferences and willingness to pay for central venous access devices in breast cancer: A multicenter discrete choice experiment

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机构: [1]School of Public Health, Fudan University, Shanghai 200032, China [2]NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai 200032, China [3]Centre for the Health Economy, Macquarie University, Macquarie Park, NSW 2109, Australia [4]Department of Nursing, Chengdu Medical College, Chengdu 610500, China [5]Department of Anesthesiology, The Second Affiliated Hospital of Air Force Military Medical University, Shaanxi 710038, China [6]Department of Breast Surgery, the First Affiliated Hospital, Zhejiang University, Hangzhou 310000, China [7]Department of Breast Surgery, Henan Provincial People's Hospital, Zhengzhou 450003, China [8]Department of Nursing, Sichuan Cancer Hospital, Chengdu 610042, China
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关键词: Central venous access devices Peripherally inserted central catheters Totally implanted ports Patient preferences Discrete choice experiment Breast cancer

摘要:
Despite being a significant management decision in clinical or nursing practice, there is limited understanding of the preferences regarding risks, benefits, costs, and other attributes of patients with breast cancer when selecting peripherally inserted central catheters or totally implanted ports. The objective of this study is to investigate the preferences of patients with breast cancer who require chemotherapy when selecting an optimal central venous access device.Data on patients' preferences for central venous access devices were collected using a face-to-face discrete choice experiment from the oncology departments of three public hospitals in China representing the eastern (Zhejiang province), central (Henan province), and western (Sichuan province) regions. The study used six attributes to describe the preferences of breast cancer patients for central venous access devices, including out-of-pocket cost, limitations in activities of daily living, catheter maintenance frequency, risk of catheter-related thrombosis, risk of catheter-related infection, and size of incision. Data were analyzed using a conditional logit model and mixed logit model. The marginal willingness to pay (mWTP) was calculated by assessing the ratio of the preference for other attributes to the preference for out-of-pocket cost.A total of 573 respondents completed the survey. The discrete choice experiment results showed that respondents strongly preferred a central venous access device with a catheter maintenance frequency of one time a month (vs four times a month, β = 1.188, p < 0.001), the lower risk of catheter-related thrombosis (2 % vs 10 %, β = 1.068; p < 0.001) and lower risk of catheter-related infection (2 % vs 8 % risk: β = 0.824; p < 0.001). Respondents were willing to pay CNY ¥11,968.1 (US$1776.5) for a central venous access device with a catheter maintenance frequency of one time a month rather than four times a month, ¥10,753.6 (US$1596.2) for a central venous access device with 2 % thrombosis risk over one with 10 %, and ¥8302.0 (US$1232.3) for a central venous access device with 2 % infection risk over one with 8 %. Respondents with longer travel time to the hospital, younger than 50 years old, and with urban employee basic medical insurance were willing to pay more for an improvement in the attributes.These findings suggest that patients with breast cancer were mainly concerned with the out-of-pocket cost, catheter maintenance frequency, risk of catheter-related thrombosis and risk of catheter-related infection when choosing a central venous access device for the delivery of chemotherapy. In clinical or nursing practice, when making central venous access device recommendation for young patients and those who live far from hospitals, totally implanted ports may be a preferable choice.Copyright © 2024 Elsevier Ltd. All rights reserved.

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大类 | 1 区 医学
小类 | 1 区 护理
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大类 | 1 区 医学
小类 | 1 区 护理
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Q1 NURSING

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第一作者机构: [1]School of Public Health, Fudan University, Shanghai 200032, China [2]NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai 200032, China
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通讯机构: [1]School of Public Health, Fudan University, Shanghai 200032, China [2]NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai 200032, China
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