Patients’, healthcare providers’, and health insurance employees’ preferences for knee and hip osteoarthritis care: a discrete choice experiment

Background Despite the wide range of treatment options for knee and hip osteoarthritis (KHOA), suboptimal care, low uptake and low adherence to treatment is widely seen. We need to gain insight into preferences for KHOA treatment.

Aim To determine patients’, healthcare providers’ and healthcare insurance employees’ preferences for existing health care for KHOA.

Method A survey containing a discrete choice experiment (DCE) was conducted. Patients with KHOA, healthcare providers (orthopaedists and GPs), and insurance employees had to choose scenarios that differed in six attributes: waiting times, out of pocket costs, travel distance, involved healthcare providers during consultation, length of consultation and access to specialist equipment. A (panel latent class) conditional logit model was used to determine the relative importance of the attributes and trade-offs that responders made, and to explore preference heterogeneity.

Results A total of 648 patients completed the DCE. All six attributes played a significant role in patients’ choices. On average, out of pocket costs were deemed undesirable by patients. A GP with an orthopaedist during the consultation was preferred compared to a GP alone. Healthcare providers (n = 76) and insurance employees (n = 150) showed similar preferences, with respect to out of pockets costs being valued less important. Latent class analysis identified four classes of patients varying in their preferences.

Conclusion Patients prefer less out of pocket costs and a GP with an orthopedists during consultation for KHOA care. Four subgroups of patients were identified that vary in preferences for KHOA care. These subgroups could provide opportunities to improve uptake, adherence and effectiveness of KHOA care.