ArticleBMC health services research2026
Preference for inpatient services among the unemployed with multi-chronic conditions: a discrete choice experiment.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCompared with single chronic diseases, multi-chronic conditions (MCCs) significantly impair patients’ daily functioning and impose economic burdens. Although China has implemented several medical reforms to standardize treatment processes and promote effective utilization of health services, patients with MCCs continue to prefer advanced medical institutions. This phenomenon is particularly prevalent among unemployed patients with MCCs. This study aims to identify the factors influencing inpatient service preferences among unemployed patients with MCCs and assess the extent to which these factors affect their decision-making.
methodsThis study conducted a discrete choice experiment (DCE) in Fuqing, Fujian Province, conducted from November 2021 to January 2022. The DCE incorporated five attributes: institutional rank, waiting times for hospital admission, travel time, acquaintances working in the hospital and average out-of-pocket expenses (OOPEs) per visit. To analyze the diverse preferences of unemployed individuals, the mixed logit model, relative importance analysis, and willingness-to-pay analysis were applied.
resultsA total of 383 unemployed patients with MCCs were identified for the study and multi-dimensional subgroup analyses were conducted. The results indicated that the overall sample group placed the greatest importance on a travel time of less than 1 h (β = 0.7487, p < 0.001), followed by preference for tertiary hospitals (β = 0.2630, p = 0.002), availability of beds on the day (β = 0.2074, p = 0.050), and lower average OOPEs per visit (β = -0.0005, p < 0.001). Subgroup analyses revealed significant differences in choice preferences based on demographic characteristics, including gender, age, and education level.
conclusionsThe inpatient service preferences of unemployed patients with MCCs are influenced by multiple factors. By examining the inpatient service choice behavior of unemployed patients with MCCs, this study provides a scientific foundation for targeted intervention strategies and supports the development of rational medical treatment behaviors. Specifically, enhancing the accessibility and service capacity of county-level hospitals may reduce travel time and average OOPEs per visit, thereby guiding patients to make rational inpatient service choices.
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