Preferences for hospital quality in Zambia: results from a discrete choice experiment
Preferences for hospital quality in Zambia: results from a discrete choice experiment
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DOI：
10.1002/hec.959
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发表时间：
2005-07-01
期刊：
影响因子：
2.1
通讯作者：
Archard, L
中科院分区：
文献类型：
--
作者：
Hanson, K;McPake, B;Archard, L
本研究报告了在赞比亚进行的离散选择实验的结果，旨在评估影响赞比亚医院护理需求的因素，特别是（感知的）质量的作用以及价格与质量之间的权衡。对成人脑型疟疾和儿童急性肺炎这两种急性疾病的治疗质量进行了评估。评估了医院护理质量属性的边际效用和支付意愿，以及社会经济特征对这些评估的影响以及时间和金钱评估的非线性程度。我们发现以检查的彻底性为代表的护理技术质量是最重要的质量属性，其次是工作人员的态度和药物的可用性。随着社会经济地位的提高，对考试彻底性的评价也随之提高。人们发现，成本的负效用随着社会经济地位的提高而降低，药物供应的价值也是如此。讨论了研究结果对赞比亚医院部门改革的影响。版权所有 (c) 2004 John Wiley & Sons, Ltd.
This study reports on the results of a discrete choice experiment undertaken in Zambia to assess the factors influencing the demand for hospital care in Zambia, in particular the role of (perceived) quality and trade-offs between price and quality. Valuations of quality were evaluated for the treatment of two acute medical conditions, cerebral malaria in adults and acute pneumonia in children. Marginal utilities and willingness-to-pay for attributes of quality of hospital care were estimated, together with the influence of socioeconomic characteristics on these valuations and the extent of non-linearities in valuations of time and money. We find the technical quality of care, as represented by the thoroughness of examination, to be the most important quality attribute, followed by staff attitudes and drug availability. Valuations of examination thoroughness increase with increasing socioeconomic status. The disutility of cost was found to decrease with higher socioeconomic status, as was the value of drug availability. The implications of the findings for Zambian hospital sector reforms are discussed. Copyright (c) 2004 John Wiley & Sons, Ltd.