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首页> 外文期刊>Social science and medicine >Investigating consumers' and informal carers' views and preferences for consumer directed care: A discrete choice experiment
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Investigating consumers' and informal carers' views and preferences for consumer directed care: A discrete choice experiment

机译：调查消费者和非正式护理人员对消费者定向护理的看法和偏好：一项离散选择实验

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Consumer directed care (CDC) is currently being embraced internationally as a means to promote autonomy and choice for consumers (people aged 65 and over) receiving community aged care services (CACSs). CDC involves giving CACS clients (consumers and informal carers of consumers) control over how CACSs are administered. However, CDC models have largely developed in the absence of evidence on clients' views and preferences. We explored CACS clients' preferences for a variety of CDC attributes and identified factors that may influence these preferences and potentially inform improved design of future CDC models. Study participants were clients of CACSs delivered by five Australian providers. Using a discrete choice experiment (DCE) approach undertaken in a group setting between June and December 2013, we investigated the relative importance to CACS consumers and informal (family) carers of gradations relating to six salient features of CDC (choice of service provider(s), budget management, saving unused/unspent funds, choice of support/care worker(s), support-worker flexibility and level of contact with service coordinator). The DCE data were analysed using conditional, mixed and generalised logit regression models, accounting for preference and scale heterogeneity. Mean ages for 117 study participants were 80 years (87 consumers) and 74 years (30 informal carers). All participants preferred a CDC approach that allowed them to: save unused funds from a CACS package for future use; have support workers that were flexible in terms of changing activities within their CACS care plan and; choose the support workers that provide their day-to-day CACSs. The CDC attributes found to be important to both consumers and informal carers receiving CACSs will inform the design of future CDC models of service delivery. The DCE approach used in this study has the potential for wide applicability and facilitates the assessment of preferences for elements of potential future aged care service delivery not yet available in policy. (C) 2015 Elsevier Ltd. All rights reserved.
机译：当前，国际上已经接受了消费者导向护理（CDC），以此作为一种手段来提高接受社区老年护理服务（CACS）的消费者（65岁及65岁以上的人群）的自主权和选择权。 CDC涉及使CACS客户（消费者和消费者的非正式护理人员）控制CACS的管理方式。但是，在缺乏有关客户观点和偏好的证据的情况下，CDC模型已在很大程度上发展。我们探讨了CACS客户对各种CDC属性的偏好，并确定了可能影响这些偏好并可能为未来CDC模型的改进设计提供帮助的因素。研究参与者是五家澳大利亚医疗机构提供的CACS的客户。我们在2013年6月至2013年12月的小组环境中采用了离散选择实验（DCE）方法，调查了与CDC六个显着特征（服务提供商的选择）有关的CACS消费者和非正式（家庭）照顾者的相对重要性），预算管理，节省未使用/未使用的资金，选择支持/护理人员，支持人员的灵活性以及与服务协调员的联系水平）。使用条件，混合和广义logit回归模型分析了DCE数据，并考虑了偏好和规模异质性。 117名研究参与者的平均年龄分别为80岁（87位消费者）和74岁（30位非正式护理者）。所有参与者都喜欢使用CDC方法，该方法允许他们：从CACS软件包中节省未使用的资金，以备将来使用;在CACS护理计划中拥有在改变活动方面具有灵活性的支持人员;并且选择提供日常CACS的支持人员。发现CDC属性对于消费者和接受CACS的非正式护理人员都很重要，这将为将来CDC服务交付模型的设计提供依据。本研究中使用的DCE方法具有广泛的应用潜力，并有助于评估对政策中尚无未来潜在的老年护理服务提供要素的偏好。 （C）2015 Elsevier Ltd.保留所有权利。

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