Study on the selection preferences for the community health management service model of older patients with multiple chronic diseases
10.3969/j.issn.1674-2982.2025.03.005
- VernacularTitle:老年多重慢性病患者对社区健康管理服务模式的选择偏好研究
- Author:
Xuan-xuan WANG
1
;
Si-yu CAI
;
Gang WANG
;
Shao-fan CHEN
;
Dong-fu QIAN
Author Information
1. 南京医科大学医政学院 江苏 南京 211166;南京医科大学数智技术与健康治理实验室 江苏 南京 211166
- Publication Type:Journal Article
- Keywords:
Older adults;
Multiple chronic diseases;
Community health management;
Service preferences;
Discrete Choice Experiments
- From:
Chinese Journal of Health Policy
2025;18(3):32-40
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study was aimed to explore the preference and heterogeneity in community health management service model selection among older patients with multiple chronic diseases,and to provide scientific evidence for optimizing the model.Methods:A multi-stage stratified and convenience sampling approach was adopted.A discrete choice experiment was conducted with 360 elderly patients with multiple chronic diseases from six regions in Jiangsu Province.The Mixed Logit Model was used to analyze service selection preferences and willingness to pay,while the Latent Class Logit Model was applied to explore heterogeneity among patient groups.Results:Patients showed a stronger preference for a service model featuring"twice-monthly visits,medication guidance+lifestyle counseling,and face-to-face consultations,"with willingness to pay values of 170.18 CNY,162.90 CNY,and 112.70 CNY,respectively.Willingness to pay decreased as out-of-pocket costs increased.Heterogeneity analysis identified three distinct preference groups,with statistically significant differences in urban-rural distribution,income levels,and health insurance types.Conclusions and suggestions:Medication and lifestyle guidance are the most valued components of community health management services among older patients with multiple chronic diseases.Patients'demographic and socioeconomic characteristics have a structural influence on their service preferences,highlighting the need to tailor service provision to different population groups.It is recommended to enhance medication guidance capacity at the primary care level,especially in rural areas;promote physical medicine integration to improve the accuracy and effectiveness of lifestyle guidance provided by primary healthcare personnel;strengthen digital infrastructure and streamline service processes to moderately increase the frequency of face-to-face consultations;and improve the integration of medical insurance and public health funding mechanisms to enhance service accessibility and equity.
