[1]许越 李雨畅 陈星宇 吴瑛 胡琳琳.基于优劣尺度法的老年人居家照护服务选择偏好及支付意愿分析[J].中国卫生质量管理,2024,31(08):023-29.[doi:10.13912/j.cnki.chqm.2024.31.8.05]
 XU Yue,LI Yuchang,CHEN Xingyu.Analysis of Elderly Individuals’ Choice Preference and Willingness to Pay for Home Care Services Based on Best-Worst Scaling[J].Chinese Health Quality Management,2024,31(08):023-29.[doi:10.13912/j.cnki.chqm.2024.31.8.05]
点击复制

基于优劣尺度法的老年人居家照护服务选择偏好及支付意愿分析()
分享到:

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第31卷
期数:
2024年08期
页码:
023-29
栏目:
特别关注
出版日期:
2024-08-15

文章信息/Info

Title:
Analysis of Elderly Individuals’ Choice Preference and Willingness to Pay for Home Care Services Based on Best-Worst Scaling
作者:
许越 李雨畅 陈星宇 吴瑛 胡琳琳
中国医学科学院 北京协和医学院卫生健康管理政策学院
Author(s):
XU YueLI YuchangCHEN Xingyu
School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College
关键词:
居家照护服务老年人选择偏好支付意愿优劣尺度法
Keywords:
Home Care ServicesElderly IndividualsChoice PreferenceWillingness to PayBest-Worst Scaling
分类号:
R197.1
DOI:
10.13912/j.cnki.chqm.2024.31.8.05
文献标志码:
A
摘要:
目的探析老年人对居家照护服务的选择偏好及支付意愿,为推动长期护理保险制度及养老服务健康发展提供参考。方法基于优劣尺度法设计问卷,通过条件Logit回归分析老年人对居家照护服务各属性的选择偏好及老年人个体特征对其偏好的影响,并计算支付意愿。结果以个人自付额为参考,老年人对居家照护服务的选择偏好为:服务内容>服务质量>是否对服务过程进行监督或收集反馈意见 (P均<0.05)。其中,老年人更偏好兼具生活照料和医疗护理的服务内容、较高的服务质量、能够进行监督或收集反馈意见的服务过程,并愿意为此分别多支付318.496元、767.508元、617.512元。老年人居家照护服务需求程度、子女数量和月均收入的差异会影响其选择偏好。结论居家照护服务发展应着力于居家医疗护理服务推广、服务质量提高和服务过程精细化管理。
Abstract:
ObjectiveTo explore the choice preference and payment willingness of older adults for home care services, and provide reference for promoting the healthy development of long-term care insurance system and elderly care services.MethodsA questionnaire was designed using the best-worst scaling method. Conditional Logit regression was used to analyze the choice preference of the elderly for each attribute of home care service and the influence of individual characteristics of the elderly on their preference, and the willingness to pay was calculated.ResultsUsing out-of-pocket costs as reference, elderly individuals ranked the importance of various attributes as follows: service content > service quality > supervision or feedback in service provision (all P<0.05). Specifically, elderly individuals preferred service content that combines daily living assistance and medical care, higher service quality, and service provision that allows for supervision or feedback, and they were willing to pay an additional ¥318.496, ¥767.508, and ¥617.512, respectively, for these attributes. The demand of older adults for home care services, the number of children and the average monthly income would affect the choice preference of the elderly.Conclusion The development of home care services should focus on promoting home-based medical care services, improving service quality, and enhancing the fine management of service processes.

参考文献/References:

[1]国家统计局.人口总量略有下降城镇化水平继续提高[EB/OL].(2023-01-18)[2024-05-01]. http://www.stats.gov.cn/xxgk/jd/sjjd2020/202301/t20230118_1892285.html.[2]LUO Y,SU B,ZHENG X.Trends and challenges for population and health during population aging-China,2015-2050[J].China CDC Weekly,2021,3(28):593-598.[3]WANG Q, ABIIRO GA, YANG J, et al. Preferences for long-term care insurance in China: results from a discrete choice experiment[J]. Social Science & Medicine,2021,281:114104.[4]王琼.城市社区居家养老服务需求及其影响因素:基于全国性的城市老年人口调查数据[J].人口研究,2016,40(1):98-112.[5]HU L, GLAVIN Y-FW, YAN R, et al. Integrating health and care in China: lessons learned and future outlook[J]. International Journal of Integrated Care,2021,21(4):18.[6]人力资源社会保障部办公厅.关于开展长期护理保险制度试点的指导意见:人社厅发〔2016〕80号[EB/OL].(2016-06-27)[2024-05-01]. http://www.mohrss.gov.cn/SYrlzyhshbzb/shehuibaozhang/zcwj/20160 7/t20160705_242951.html.[7]国务院.关于印发“十三五”国家老龄事业发展和养老体系建设规划的通知:国发〔2017〕13号[EB/OL].(2017-03-06)[2024-05-01]. https://www.gov.cn/zhengce/content/2017-03/06/content_51 73930.htm.[8]国家医疗保障局,财政部.关于扩大长期护理保险制度试点的指导意见:医保发〔2020〕37号[EB/OL].(2020-09-10)[2024- 05-01].https://www.gov.cn/gongbao/content/2020/content_5570107.htm.[9]POTOGLOU D, BURGE P, FLYNN T, et al. Best-worst scaling vs. discrete choice experiments: an empirical comparison using social care data[J]. Social Science & Medicine,2011,72(10):1717-1727.[10]姜玉贞.社区居家养老服务多元供给主体治理困境及其应对[J].东岳论丛,2017,38(10):45-53.[11]陈友华.居家养老及其相关的几个问题[J].人口学刊,2012(4):51-59.[12]RYAN M, GERARD K. Using discrete choice experiments to value health care programmes: current practice and future research reflections[J]. Applied Health Economics and Health Policy,2003,2(1):55-64.[13]CHEUNG KL,WIJNEN BFM, HOLLIN IL, et al. Using best-worst scaling to investigate preferences in health care[J].Pharmacoeconomics,2016,34(12):1195-1209.[14]DE BEKKER-GROB EW, RYAN M, GERARD K. Discrete choice experiments in health economics: a review of the literature[J].Pharmacoeconomics,2012,21(2):145-172.[15]SOEKHAI V, DE BEKKER-GROB EW, ELLIS AR, et al. Discrete choice experiments in health economics: past, present and future[J]. Pharmacoeconomics,2019,37(2):201-226.[16]苏天园,李豫凯,张其其,等.基于离散选择实验的乌鲁木齐市居民健康管理服务选择偏好研究[J].中国全科医学,2021,24(16):2015-2021.[17]郑吕云,曾令黄,刘志刚,等.基于离散选择实验的医务人员激励偏好研究[J].中国卫生质量管理,2024,31(4):59-62.[18]吴爽,邓茜月,曹志辉,等.居民对家庭医生签约服务的需求偏好研究:基于离散选择实验[J].卫生经济研究,2021,38(5):18-21.[19]张娇,徐凌忠.离散选择实验在我国卫生服务领域的应用与展望[J].卫生软科学,2022,36(11):32-35. [20]FINN A, LOUVIERE JJ. Determining the appropriate response to evidence of public concern: the case of food safety[J]. Journal of Public Policy & Marketing,1992,11(2):12-25.[21]任延峰,刘世蒙,陶颖,等.抑郁症患者药物治疗偏好的系统综述:基于离散选择实验和优劣尺度法[J].中国全科医学,2023,26(28):3559-3564.[22]张录法,黄姣姣,王慧,等.优劣尺度法理论及应用研究述评[J]. 统计与信息论坛,2019,34(3):24-30. [23]FLYNN TN, LOUVIERE JJ, PETERS TJ, et al. Best-worst scaling: What it can do for health care research and how to do it[J]. Journal of Health Economics,2007,26(1):171-189.[24]FLYNN TN. Valuing citizen and patient preferences in health: recent developments in three types of best-worst scaling[J]. Expert Review of Pharmacoeconomics & Outcomes Research,2010,10(3):259-267.[25]陈志科,马少珍.老年人居家养老服务需求的影响因素研究:基于湖南省的社会调查[J].中南大学学报(社会科学版),2012,18(3):26-30,74.[26]章晓懿,梅强.影响社区居家养老服务质量的因素研究:个体差异的视角[J].上海交通大学学报(哲学社会科学版),2011,19(6):23-30.[27]MCCAFFREY N, GILL L, KAAMBWA B, et al. Important features of home-based support services for older Australians and their informal carers[J]. Health Soc Care Community,2015,23(6):654-664.[28]AMILON A, LADENBURG J, SIREN A, et al. Willingness to pay for long-term home care services: evidence from a stated preferences analysis[J]. The Journal of the Economics of Ageing,2020,17:100238.[29]WALSH S, O’SHEA E, PIERSE T, et al. Public preferences for home care services for people with dementia: a discrete choice experiment on personhood[J].Social Science & Medicine,2020,245:112675.[30]DIXON S, NANCARROW SA, ENDERBY PM, et al. Assessing patient preferences for the delivery of different community-based models of care using a discrete choice experiment[J]. Health Expect,2015,18(5):1204-1214.[31]LEHNERT T, GUNTHER OH, HAJEK A, et al. Preferences for home- and community-based long-term care services in Germany: a discrete choice experiment[J]. The European Journal of Health Economics,2018,19(9):1213-1223.[32]CHEN G, RATCLIFFE J, MILTE R, et al. Quality of care experience in aged care: an Australia-wide discrete choice experiment to elicit preference weights[J].Social Science & Medicine,2021,289:114440.[33]AHMED T, ASSEFA N, DEMISIE A, et al. Levels of adult patients’ satisfaction with nursing care in selected public hospitals in ethiopia[J].International Journal of Health Sciences,2014,8(4):371-379.[34]HOLLIN IL, PASKETT J, SCHUSTER ALR, et al. Best-worst scaling and the prioritization of objects in health: a systematic review[J]. Pharmacoeconomics,2022,40(9):883-899.[35]AIZAKI H, FOGARTY J. An R package and tutorial for case 2 best-worst scaling[J].Journal of Choice Modelling,2019,32:100171.[36]MEREGAGLIA M, MANFREDI S, PEROBELLI E, et al. P13 carer preferences and willingness-to-pay for home care services for older people with dementia: a discrete choice experiment in the Milan metropolitan area[J].Value in Health,2023,26(12):S3.[37]NIKBAKHT NASRABADI A, SHAHSAVARI H, ALMASIAN M, et al. Designing a process model of home care service delivery in Iran: a mixed methods study[J].International Journal of Community Based Nursing & Midwifery,2019,7(4):288-299.[38]北京市石景山区人民政府办公室.石景山区长期护理保险制度试点方案(试行):石政办发〔2018〕4号[EB/OL].(2018-03-15)[2024-05-01]. https://www.beijing.gov.cn/zhengce/zhengcefagui/20190 5/t20190522_60978.html.[39]严梦悦.我国长期护理保险政策比较研究[D].上海:华东政法大学,2022.[40]张丹,罗娟,朱亦枫.我国5个城市长期护理保险试点情况的比较研究[J].医学与社会,2023,36(1):93-98,104.[41]LOUVIERE JJ, FLYNN TN, MARLEY AAJ. Best-worst scaling: theory, methods and applications[M]. Cambridge: Cambridge University Press, 2015: 56-88.[42]XU RH, ZHOU L, WONG EL-Y, et al. A best-worst scaling survey of medical students’ perspective on implementing shared decision-making in China[J]. BMC Medical Education,2020,20(1):486.[43]LANCSAR E, LOUVIERE J. Conducting discrete choice experiments to inform healthcare decision making[J].Pharmaco economics,2008,26(8):661-677.[44]殷悦,池卓源,赵明烨,等.基于优劣尺度法的医患双方对药品临床综合评价各维度的偏好与支付意愿研究[J].医学与社会,2022,35(5):108-112.[45]HOLE AR. A comparison of approaches to estimating confidence intervals for willingness to pay measures[J].Health Economics,2007,16(8):827-840.[46]FLYNN TN, LOUVIERE JJ, PETERS TJ, et al. Estimating preferences for a dermatology consultation using best-worst scaling: comparison of various methods of analysis[J].BMC Medical Research Methodology,2008,8(1):76.[47]李萌萌.多子女居民养老模式选择的影响因素探究[D].太原:山西财经大学,2023.[48]曾起艳,何志鹏,曾寅初.老年人居家养老服务的偏好模式与归因分析[J].西北人口,2023,44(5):58-69.[49]CHUNG MH, HSU N, WANG YC, et al. Factors affecting the long-term care preferences of the elderly in Taiwan[J].Geriatric Nursing,2008,29(5):293-301.[50]贺小林,梁 燕.城市高龄老人居家照护服务利用与政策优化:基于群体差异的潜在类别分析[J].上海行政学院学报,2023,24(4):97-111.[51]卢 珊, 杜宝贵.基于修订Andersen模型的辽宁省城市老年人养老方式选择偏好及其影响因素研究[J].中国卫生事业管理,2020,37(11):853-858.[52]国家卫生健康委办公厅,国家中医药管理局办公室.关于加强老年人居家医疗服务工作的通知:国卫办医发〔2020〕24号[EB/OL].(2020-12-17)[2024-05-01]. http://www.nhc.gov.cn/yzygj/s7653 pd/202012/19a2617ba8e641bea9ac2472ea04c 82a.shtml.[53]北京市卫生健康委员会, 北京市中医管理局.关于印发北京市加强老年人居家医疗服务工作实施方案的通知[EB/OL].(2023-08-22)[2024-05-01].https://wjw.beijing.gov.cn/zwgk_20040/ylws/202 308/t20230822_3227836.html.[54]TOLKACHEVA N, BROESE VAN GROENOU M, VAN TILBURG T. Sibling influence on care given by children to older parents[J].Research on Aging,2010,32(6):739-759.

相似文献/References:

[1]薛梓晨秘玉清陈倩邢家润黄静雯寇儒欣邓神根李伟.山东省社区卫生服务中心老年慢病管理脆弱性评价研究[J].中国卫生质量管理,2023,30(08):075.[doi:10.13912/j.cnki.chqm.2023.30.8.16 ]
 XUE Zichen,MI Yuqing,CHEN Qian.Vulnerability Evaluation of Elderly Chronic Disease Management in Community Health Service Centers of Shandong Province[J].Chinese Health Quality Management,2023,30(08):075.[doi:10.13912/j.cnki.chqm.2023.30.8.16 ]

更新日期/Last Update: 2024-08-15