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General practitioners' preferences for the organisation of primary care: a discrete choice experiment
Line Bjørnskov Pedersen1, Trine Kjær, Jakob Kragstrup
1University of Southern Denmark, Institute of Public Health, Research Unit of Health Economics, J.B. Winsløwsvej 9B, 5000 Odense C, Denmark. lib@sam.sdu.dk
Objectives:
To examine GPs' preferences for organisational characteristics in general practice with focus on aspects that can potentially mitigate problems with GP shortages.
Methods:
A simple random sample of 1823 GPs (corresponding to half of all GPs in Denmark) was drawn at the beginning of 2010, and a response rate of 68% was obtained. A discrete choice experiment (DCE) is applied, and attributes included are: practice type (solo/shared), number of GPs in general practice, collaboration with other practices (yes/no), change in weekly working hours (administrative versus patient related) and change in yearly surplus. Multinomial logit analyses (with and without interaction variables) are used, and marginal rates of substitution are calculated.
Results:
GPs working in solo practices have different preferences for the organisational attributes compared to GPs in shared practices. The compensation needed for GPs to re-organise from solo to shared practice is associated with the size of the practice. GP characteristics such as age, working hours and surplus affect their willingness to undergo organisational changes.
Conclusions:
Our results are of relevance to decision makers in designing policies aimed at influencing GPs' organisation in order to overcome problems related to shortages.
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