Patient preferences for diagnostic imaging services: Decentralize or not?

The objective of this study was to identify patient preferences for outpatient diagnostic imaging services and analyze how patients make trade-offs between attributes of these services using a discrete choice experiment (DCE). We used a DCE with 14 choice questions asking which imaging locations patients would prefer. We used latent class analysis to analyze preference heterogeneity between different patient groups and to estimate the relative value they assign to different attributes of imaging services. Our analysis showed that the "Experienced Patients" subgroup generally value diagnostic imaging services in both acute and chronic situations and had a strong preference for hospital outpatient radiology departments (HORD) that would provide services at lower costs, where their images would be interpreted by a specialty radiologist, the clinic would be recommended by their PCP, online scheduling would be available, service rating were higher, and travel and wait times would be shorter. New Patients significantly valued the service rating of the (HORD and online scheduling. HORDs can be more competitive by providing services that live up to expectations better than available retail radiology clinics (RRCs). Most RRCs do not currently offer online scheduling so ease of use may also steer patients towards HORDs. HORDs have the advantage of being linked to the main medical center which has the reputation of having clinical expertise and more sophisticated technology. We conclude that there is room for medical centers to build HORDs that provide an appealing and competitive alternative to current RRC.