Preferences for hospital quality in Zambia: results from a discrete choice experiment
通过赞比亚的离散选择实验,评估医院质量属性(如检查彻底性、员工态度、药品可得性)对患者选择的影响,并分析社会经济地位如何影响这些偏好和支付意愿。
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.