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Analysis of the Factors Affecting Patient's Choice of Health Provider, and an Estimation of Marginal Willingness to Pay for Better Service Quality, Using Multinomial Logit Model

تحليل العوامل المؤثرة في خيارات المريض لمقدم خدمة الرعاية الصحية، و تقدير الرغبة الحدية بالدفع للحصول على خدمة بمواصفات أفضل باستخدام الانحدار المنطقي المتعدد

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 Publication date 2016
and research's language is العربية
 Created by Shamra Editor




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The aim of the study is two folds. First, it aims at analyzing the factors affecting Patient's choice of health service provider (Private clinic, public hospital, or private hospital). This study applies a multinomial logit model (MNL) to analyze patient's choice, using a sample of 695 respondents drawn from Damascus City. Second, the study estimates the marginal willingness to pay for an extra gain from a specific change in each of the characteristics of health provider, such as reputation and waiting time. Analysis results were as follows: - Perceived reputation of the health provider is the most important factor affecting the patient's choice of health provider. - Ironically, higher treatment cost is associated with higher probability of choosing the more expensive health provider alternative. - The choice of a specific health provider against another is negatively associated with associated commuting time. - Waiting time at the private clinic has no significant effect on patient's choice of the private clinic. - Marginal willingness to pay for extra level on perceived reputation index of a private clinic is estimated at US$1.41, and US$0.07 for an extra hour saved of waiting time. - Marginal willingness to pay for extra level on perceived reputation index of a private hospital is estimated at US$1.06, and US$4.79 for an extra hour saved of waiting time. - Patient's demographic characteristics have an insignificant effect on the choice of a specific health provider against another. The study recommends health providers to enhance the level of their professional reputation as it turned out to be the most crucial factor affecting patient's choice, and at the same time keep on improving other factors such as internal procedures, waiting time, and location.

References used
related to health care services at hospital in Amhara Region, northern Ethiopia: a discrete choice experiment", Dove Medical press, No.9, PP. 1293 – 1301
Anen,R. AND Terje PH. (2011) "Are waiting times for hospital admissions affected by patients' choices and mobility", BMC Health Services Research, Vol.11,No.170
Dijs _ Elsinga J. (2010) "Choosing a hospital for surgery: The importance of information on quality of care", International Journal of The Medical Decision Making, Vol.30, No.5, PP.55-544

Artificial intelligence review:
Research summary
تهدف الدراسة إلى تحليل العوامل المؤثرة في خيارات المرضى لمقدم خدمة الرعاية الصحية (عيادة خاصة، مشفى عام، أو مشفى خاص) في مدينة دمشق، وتقدير الرغبة الحدية بالدفع للحصول على خدمة بمواصفات أفضل باستخدام نموذج الانحدار المنطقي المتعدد. استندت الدراسة إلى عينة إحصائية مكونة من 695 مبحوثاً. توصلت الدراسة إلى أن سمعة مقدم الخدمة هي العامل الأكثر أهمية في اختيار المرضى، حيث تزداد الرغبة الحدية بالدفع بمقدار 1.41 دولار لكل درجة إضافية على مؤشر سمعة العيادة الخاصة و0.07 دولار لتوفير ساعة انتظار. كما تزداد الرغبة الحدية بالدفع بمقدار 1.06 دولار لكل درجة إضافية على مؤشر سمعة المشفى الخاص و4.79 دولار لتوفير ساعة انتظار. أوصت الدراسة بضرورة تحسين سمعة مقدمي خدمات الرعاية الصحية مع مراعاة العوامل الأخرى مثل الموقع وإجراءات تقديم الخدمة.
Critical review
دراسة نقدية: الدراسة تقدم إسهاماً مهماً في فهم العوامل المؤثرة في اختيار المرضى لمقدمي خدمات الرعاية الصحية، إلا أنها تعتمد بشكل كبير على العينة المأخوذة من مدينة دمشق فقط، مما قد يحد من تعميم النتائج على مناطق أخرى. كما أن الدراسة لم تأخذ في الاعتبار العوامل النفسية والاجتماعية التي قد تؤثر على قرارات المرضى. بالإضافة إلى ذلك، كان من الممكن أن تكون الدراسة أكثر شمولاً إذا تضمنت تحليلاً نوعياً لمزيد من الفهم العميق لتجارب المرضى وآرائهم.
Questions related to the research
  1. ما هو العامل الأكثر أهمية في اختيار المرضى لمقدم خدمة الرعاية الصحية وفقاً للدراسة؟

    العامل الأكثر أهمية هو سمعة مقدم الخدمة.

  2. كيف تؤثر تكلفة الخدمة على اختيار المرضى لمقدم خدمة الرعاية الصحية؟

    كلما ازدادت تكلفة الخدمة، ازداد احتمال اختيار البديل الأكثر تكلفة.

  3. ما هو تأثير زمن الانتظار في المشفى الخاص على اختيار المرضى؟

    كلما ازداد زمن الانتظار في المشفى الخاص، انخفض احتمال اختياره.

  4. هل للخصائص الديموغرافية للمرضى تأثير على قراراتهم بخصوص البديل المفضل لتلقي خدمات الرعاية الصحية؟

    لا يوجد أثر ذو دلالة إحصائية للخصائص الديموغرافية للمرضى على قراراتهم.

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