Choosing Video Instead of In-Clinic Consultations in Primary Care in Israel: Discrete Choice Experiment Among Key Stakeholders—Patients, Primary Care Physicians, and Policy Makers

Irit Chudner, Anat Drach-Zahavy, Khaled Karkabi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Despite its innovative benefits, the adoption of video consultations (VCs) in primary care settings is complex and slow. Objectives: To quantify the preferences of key stakeholders in Israel's primary care—patients, primary care practitioners, and policy makers—regarding VCs compared with traditional in-clinic consultations (ICC) in nonurgent conditions. Methods: Discrete choice experiment surveys were completed by 508 patients, 311 physicians, and 141 policy makers. These consisted of 12 choice tasks of 2 labeled alternatives (VC or ICC), with the 4 attributes most relevant to each stakeholder group. A random effects logit model analysis was used to estimate stakeholders' preferences. Results: All 4 experiments' attributes were significantly important in choosing VC versus ICC for the patient group and the physician group. Three out of 4 attributes were significantly important to policy makers. Differences and similarities between stakeholders were identified in attribute rank order, trade-offs, and VC uptake probabilities. Policy makers' VC uptake rate was 86%. Patients' preferences suggested that 68% of ICCs could be replaced by VCs. Physicians' VC uptake was 30% in cases in which the consultation purpose was to diagnose and provide treatment and 48% in cases in which the consultation purpose was follow-up. Conclusions: Our findings show key stakeholders' preferences about VC integration, to be considered when these systems are introduced into primary care and optimize the implementation process. Although there is a stronger preference for ICC among physicians and patients, alternative combinations of attribute levels might be used to compensate and reconfigure a more preferred VC service.

Original languageEnglish
Pages (from-to)1187-1196
Number of pages10
JournalValue in Health
Volume22
Issue number10
DOIs
StatePublished - Oct 2019

Bibliographical note

Publisher Copyright:
© 2019 ISPOR–The Professional Society for Health Economics and Outcomes Research

Keywords

  • discrete choice experiment (DCE)
  • primary care
  • stakeholder's preferences
  • stated preferences
  • telemedicine
  • video consultation (VC)

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy

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