Patient preferences for facility-based management of hypertension and diabetes in rural Uganda: a discrete choice experiment.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
21 07 2022
Historique:
entrez: 21 7 2022
pubmed: 22 7 2022
medline: 26 7 2022
Statut: epublish

Résumé

To explore how respondents with common chronic conditions-hypertension (HTN) and diabetes mellitus (DM)-make healthcare-seeking decisions. Three health facilities in Nakaseke District, Uganda. Discrete choice experiment (DCE). 496 adults with HTN and/or DM. Willingness to pay for changes in DCE attributes: getting to the facility, interactions with healthcare providers, availability of medicines for condition, patient peer-support groups; and education at the facility. Respondents were willing to pay more to attend facilities that offer peer-support groups, friendly healthcare providers with low staff turnover and greater availabilities of medicines. Specifically, we found the average respondent was willing to pay an additional 77 121 Ugandan shillings (UGX) for facilities with peer-support groups over facilities with none; and 49 282 UGX for 1 month of medicine over none, all other things being equal. However, respondents would have to compensated to accept facilities that were further away or offered health education. Specifically, the average respondent would have to be paid 3929 UGX to be willing to accept each additional kilometre they would have to travel to the facilities, all other things being equal. Similarly, the average respondent would have to be paid 60 402 UGX to accept facilities with some health education, all other things being equal. Our findings revealed significant preferences for health facilities based on the availability of medicines, costs of treatment and interactions with healthcare providers. Understanding patient preferences can inform intervention design to optimise healthcare service delivery for patients with HTN and DM in rural Uganda and other low-resource settings.

Identifiants

pubmed: 35863829
pii: bmjopen-2021-059949
doi: 10.1136/bmjopen-2021-059949
pmc: PMC9310153
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e059949

Subventions

Organisme : FIC NIH HHS
ID : K01 TW009995
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States

Informations de copyright

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Références

Value Health. 2018 Oct;21(10):1192-1197
pubmed: 30314620
Value Health. 2011 Jun;14(4):403-13
pubmed: 21669364
Value Health. 2013 Jan-Feb;16(1):3-13
pubmed: 23337210
PLoS One. 2020 Jul 7;15(7):e0235696
pubmed: 32634164
BMJ. 1995 Aug 5;311(7001):376-80
pubmed: 7640549
J Clin Epidemiol. 2008 Apr;61(4):344-9
pubmed: 18313558
J Gen Intern Med. 2011 Nov;26 Suppl 2:648-54
pubmed: 21989617
BMJ Open. 2019 Oct 7;9(10):e031773
pubmed: 31594895
Fam Med. 2009 Apr;41(4):271-6
pubmed: 19343558
PLoS One. 2020 Dec 23;15(12):e0241555
pubmed: 33362249
J Gen Intern Med. 2019 Jul;34(7):1167-1173
pubmed: 30997637
Health Policy Plan. 2009 Mar;24(2):151-8
pubmed: 19112071
BMC Health Serv Res. 2018 Aug 6;18(1):606
pubmed: 30081898
Ann Glob Health. 2021 Aug 19;87(1):86
pubmed: 34458110
Diabetes Res Clin Pract. 2014 Feb;103(2):137-49
pubmed: 24630390
J Int AIDS Soc. 2016 Feb 10;19(1):20171
pubmed: 26869359
Patient Prefer Adherence. 2017 Sep 26;11:1635-1646
pubmed: 29033551
Diabetes Metab Syndr Obes. 2017 Jun 22;10:247-263
pubmed: 28790858
Qual Health Res. 2005 Nov;15(9):1277-88
pubmed: 16204405
Int J Equity Health. 2021 Jan 18;20(1):38
pubmed: 33461568
PLoS Med. 2018 Aug 13;15(8):e1002636
pubmed: 30102693
Lancet. 2005 Jan 15-21;365(9455):217-23
pubmed: 15652604
BMJ Glob Health. 2018 Jan 13;2(Suppl 3):e000644
pubmed: 29531844
Health Aff (Millwood). 2015 Sep;34(9):1506-13
pubmed: 26355052
AIDS Care. 2014;26(11):1352-8
pubmed: 24517083
Value Health. 2019 Feb;22(2):157-160
pubmed: 30711059
PLoS Med. 2010 May 11;7(5):e1000244
pubmed: 20485489
J Community Health. 2013 Oct;38(5):976-93
pubmed: 23543372
Fam Pract. 2017 Jun 1;34(3):358-363
pubmed: 28043961
Appl Health Econ Health Policy. 2020 Jun;18(3):413-432
pubmed: 31981135
Lancet. 2016 Aug 20;388(10046):761-75
pubmed: 27431356
PLoS One. 2015 Aug 11;10(8):e0135621
pubmed: 26262840
Public Health Action. 2019 Sep 21;9(3):102-106
pubmed: 31803581
J Acquir Immune Defic Syndr. 2018 Aug 15;78 Suppl 2:S124-S127
pubmed: 29994834
Health Policy Plan. 2015 Jun;30(5):600-11
pubmed: 24876077
BMJ Glob Health. 2019 May 31;4(3):e001509
pubmed: 31263591
Circulation. 2005 Dec 6;112(23):3554-61
pubmed: 16330696
J Hum Hypertens. 2022 Mar 4;:
pubmed: 35246602
Diabetes Educ. 2020 Jun;46(3):230-241
pubmed: 32321370
BMC Health Serv Res. 2012 Jul 23;12:212
pubmed: 22824497
Curr HIV/AIDS Rep. 2020 Oct;17(5):467-477
pubmed: 32860150

Auteurs

Sarah Eg Moor (SE)

Yale School of Medicine, New Haven, Connecticut, USA sarah.moor@yale.edu.

Andrew K Tusubira (AK)

Uganda Initiative for Integrated Management of Non-communicable Diseases, Kampala, Uganda.

Dallas Wood (D)

Center for Applied Economics and Strategy, RTI International, Research Triangle Park, North Carolina, USA.

Ann R Akiteng (AR)

Uganda Initiative for Integrated Management of Non-communicable Diseases, Kampala, Uganda.

Deron Galusha (D)

Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, USA.

Baylah Tessier-Sherman (B)

Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, USA.

Evelyn Hsieh Donroe (EH)

Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Yale Network for Global Non-communicable Diseases, Yale University, New Haven, Connecticut, USA.

Christine Ngaruiya (C)

Yale Network for Global Non-communicable Diseases, Yale University, New Haven, Connecticut, USA.
Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA.

Tracy L Rabin (TL)

Uganda Initiative for Integrated Management of Non-communicable Diseases, Kampala, Uganda.
Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Yale Network for Global Non-communicable Diseases, Yale University, New Haven, Connecticut, USA.

Nicola L Hawley (NL)

Yale Network for Global Non-communicable Diseases, Yale University, New Haven, Connecticut, USA.
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA.

Mari Armstrong-Hough (M)

Department of Social and Behavioral Sciences and Department of Epidemiology, School of Global Public Health, New York University, New York, New York, USA.

Brenda D Nakirya (BD)

Community Concerns Uganda Initiative, Jinja, Uganda.

Rachel Nugent (R)

Global Non-Communicable Diseases, RTI International, Seattle, Washington, USA.

Robert Kalyesubula (R)

African Community for Social Sustainability, Nakaseke, Uganda.
Department of Internal Medicine, Makerere University School of Medicine, Kampala, Uganda.

Christine Nalwadda (C)

Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda.

Isaac Ssinabulya (I)

Uganda Initiative for Integrated Management of Non-communicable Diseases, Kampala, Uganda.
Department of Internal Medicine, Makerere University School of Medicine, Kampala, Uganda.

Jeremy I Schwartz (JI)

Uganda Initiative for Integrated Management of Non-communicable Diseases, Kampala, Uganda.
Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, USA.
Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Yale Network for Global Non-communicable Diseases, Yale University, New Haven, Connecticut, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH