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Understanding Patients’ Choices at the Point of Referral
The UK Department of Health is implementing a new system for GP specialist referrals, which will give NHS patients a choice of the hospital to which they will be referred. As of January 1st 2006, patients are being offered a choice of around five hospitals, pre-selected by their local primary care trust (PCT). By 2008, it is planned that all patients requiring a first outpatient attendance will have the choice of any NHS hospital (or private sector hospital contracting with the NHS) in England. This report details research undertaken jointly by RAND Europe, City University and the Kings Fund to investigate which factors are likely to drive patients’ choices at the point of referral. The research team used stated preference discrete choice experiments to explore the priorities of patients, from which they estimated discrete choice models. These provide some insights not only into the types of information patients require, but also the value patients place on specific aspects of hospitals’ performance and, more generally, their characteristics. The modelling results inform policy makers of the potential benefits of different ways of structuring and informing patients’ choices.
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Contents
Chapter One:
Introduction
Chapter Two:
Discrete choice modelling method
Chapter Three:
Research design
Chapter Four:
Data collected
Chapter Five:
Modelling
Chapter Six:
Interpretation of model results
Chapter Seven:
Areas for further research
Appendix A:
Recruitment questionnaire
Appendix B:
London and Norwich patient choice workshops
Appendix C:
Final questionnaire
Appendix D:
Conclusions from the pilots of the survey
Appendix E:
Experimental design
Appendix F:
Example choice card introduction
Appendix G:
Detailed feedback on the discrete choice exercise
Appendix H:
Modelling checks on ordering effects
Appendix I:
The jack-knife procedure
The research described in this report was prepared for the UK Department of Health and was conducted by RAND Europe.
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