Abstract:
Eliciting patient preferences and involving these preferences into health policy discussions around health care service provision can be argued to be one of the key steps forward in future health care reform. The aim of this thesis was to elicit patient preferences for after hours health care in Auckland, New Zealand. Through utilising a discrete choice experiment, a questionnaire was administered with participants across 6 after hours practices in Auckland. The four attributes investigated within this research were cost, waiting time, travel distance and quality of care. Probit regression was used to produce coefficients which show the strength of preferences for each of the listed attributes. It was found that participants had the strongest preference for a comprehensive quality of care, followed by no cost for consultation, shorter travel distance to the clinics and reduced waiting time before being seen by a nurse and/or doctor. It was also found that longer travel distances, followed by high cost of consultation, longer waiting times and poor quality of care significantly reduced the chances of a clinic being utilised. All of these above findings were shown to be statistically significant with only some findings from the subgroup analyses being of significance, These findings suggest that patients decision making behaviours are significantly affected by these four attributes in relation to after hours health care in Auckland. In conclusion, patient preferences for after hours health care have a strong case for having a potential role in shaping provision of these services. Understanding these preferences allow after hours care to be better suited towards meeting patient needs and therefore increasing overall patient satisfaction. Alongside this, shaping care through targeting specific sociodemographic groups has the potential for reduced barriers towards entry into after hours health care, such as cost and travel barriers, therefore reducing inequities in unmet needs for after hours health care.