Choosing Video Instead of In-Clinic Consultations in Primary Care in Israel: Discrete Choice Experiment Among Key Stakeholders—Patients, Primary Care Physicians, and Policy Makers

Despite its innovative benefits, the adoption of video consultations (VCs) in primary care settings is complex and slow. To quantify the preferences of key stakeholders in Israel's primary care—patients, primary care practitioners, and policy makers—regarding VCs compared with traditional in-cl...

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Veröffentlicht in:Value in health 2019-10, Vol.22 (10), p.1187-1196
Hauptverfasser: Chudner, Irit, Drach-Zahavy, Anat, Karkabi, Khaled
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Karkabi, Khaled
description Despite its innovative benefits, the adoption of video consultations (VCs) in primary care settings is complex and slow. To quantify the preferences of key stakeholders in Israel's primary care—patients, primary care practitioners, and policy makers—regarding VCs compared with traditional in-clinic consultations (ICC) in nonurgent conditions. Discrete choice experiment surveys were completed by 508 patients, 311 physicians, and 141 policy makers. These consisted of 12 choice tasks of 2 labeled alternatives (VC or ICC), with the 4 attributes most relevant to each stakeholder group. A random effects logit model analysis was used to estimate stakeholders' preferences. All 4 experiments' attributes were significantly important in choosing VC versus ICC for the patient group and the physician group. Three out of 4 attributes were significantly important to policy makers. Differences and similarities between stakeholders were identified in attribute rank order, trade-offs, and VC uptake probabilities. Policy makers' VC uptake rate was 86%. Patients' preferences suggested that 68% of ICCs could be replaced by VCs. Physicians' VC uptake was 30% in cases in which the consultation purpose was to diagnose and provide treatment and 48% in cases in which the consultation purpose was follow-up. Our findings show key stakeholders' preferences about VC integration, to be considered when these systems are introduced into primary care and optimize the implementation process. Although there is a stronger preference for ICC among physicians and patients, alternative combinations of attribute levels might be used to compensate and reconfigure a more preferred VC service. •Various preferences of key stakeholder groups in primary care need to be taken into consideration in the prospective implementation of video consultations (VCs). The preferences of 3 key stakeholders (patients, physicians, and policy makers) regarding VC versus in-clinic consultation (ICC) choice have been under-researched.•This study presents empirical parallel preference elicitation among 3 key VC stakeholder groups.•Time until the next appointment, queuing time before the consultation, relationship with physician, quality of consultation, patient's self-management ability, and purpose of consultation were statistically significant attributes for stakeholders' VC versus ICC choice and varied in the ranking. Patients' and physicians' uptake rates were lower than those of policy makers. Physicians rated VC co
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The preferences of 3 key stakeholders (patients, physicians, and policy makers) regarding VC versus in-clinic consultation (ICC) choice have been under-researched.•This study presents empirical parallel preference elicitation among 3 key VC stakeholder groups.•Time until the next appointment, queuing time before the consultation, relationship with physician, quality of consultation, patient's self-management ability, and purpose of consultation were statistically significant attributes for stakeholders' VC versus ICC choice and varied in the ranking. Patients' and physicians' uptake rates were lower than those of policy makers. 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Patients' preferences suggested that 68% of ICCs could be replaced by VCs. Physicians' VC uptake was 30% in cases in which the consultation purpose was to diagnose and provide treatment and 48% in cases in which the consultation purpose was follow-up. Our findings show key stakeholders' preferences about VC integration, to be considered when these systems are introduced into primary care and optimize the implementation process. Although there is a stronger preference for ICC among physicians and patients, alternative combinations of attribute levels might be used to compensate and reconfigure a more preferred VC service. •Various preferences of key stakeholder groups in primary care need to be taken into consideration in the prospective implementation of video consultations (VCs). The preferences of 3 key stakeholders (patients, physicians, and policy makers) regarding VC versus in-clinic consultation (ICC) choice have been under-researched.•This study presents empirical parallel preference elicitation among 3 key VC stakeholder groups.•Time until the next appointment, queuing time before the consultation, relationship with physician, quality of consultation, patient's self-management ability, and purpose of consultation were statistically significant attributes for stakeholders' VC versus ICC choice and varied in the ranking. Patients' and physicians' uptake rates were lower than those of policy makers. 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To quantify the preferences of key stakeholders in Israel's primary care—patients, primary care practitioners, and policy makers—regarding VCs compared with traditional in-clinic consultations (ICC) in nonurgent conditions. Discrete choice experiment surveys were completed by 508 patients, 311 physicians, and 141 policy makers. These consisted of 12 choice tasks of 2 labeled alternatives (VC or ICC), with the 4 attributes most relevant to each stakeholder group. A random effects logit model analysis was used to estimate stakeholders' preferences. All 4 experiments' attributes were significantly important in choosing VC versus ICC for the patient group and the physician group. Three out of 4 attributes were significantly important to policy makers. Differences and similarities between stakeholders were identified in attribute rank order, trade-offs, and VC uptake probabilities. Policy makers' VC uptake rate was 86%. Patients' preferences suggested that 68% of ICCs could be replaced by VCs. Physicians' VC uptake was 30% in cases in which the consultation purpose was to diagnose and provide treatment and 48% in cases in which the consultation purpose was follow-up. Our findings show key stakeholders' preferences about VC integration, to be considered when these systems are introduced into primary care and optimize the implementation process. Although there is a stronger preference for ICC among physicians and patients, alternative combinations of attribute levels might be used to compensate and reconfigure a more preferred VC service. •Various preferences of key stakeholder groups in primary care need to be taken into consideration in the prospective implementation of video consultations (VCs). The preferences of 3 key stakeholders (patients, physicians, and policy makers) regarding VC versus in-clinic consultation (ICC) choice have been under-researched.•This study presents empirical parallel preference elicitation among 3 key VC stakeholder groups.•Time until the next appointment, queuing time before the consultation, relationship with physician, quality of consultation, patient's self-management ability, and purpose of consultation were statistically significant attributes for stakeholders' VC versus ICC choice and varied in the ranking. Patients' and physicians' uptake rates were lower than those of policy makers. 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source Applied Social Sciences Index & Abstracts (ASSIA); Elsevier ScienceDirect Journals Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
subjects Attributes
Discrete choice
discrete choice experiment (DCE)
Integrated care
Patients
Physicians
Policy making
Primary care
Random effects
stakeholder's preferences
Stakeholders
stated preferences
telemedicine
Uptake
video consultation (VC)
title Choosing Video Instead of In-Clinic Consultations in Primary Care in Israel: Discrete Choice Experiment Among Key Stakeholders—Patients, Primary Care Physicians, and Policy Makers
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