What do Iranians value most when choosing a hospital? Evidence from a discrete choice experiment

Individual preferences have preceded the use of health care services, and it has been affected by different hospital attributes. This study aimed to elicit the Iranians' preferences in choosing hospitals using a discrete choice experiment.

A discrete choice experiment (DCE) was conducted through face to face interviews with 301 participants. The DCE was constructed by six attributes were included based on a literature review, qualitative interviews, Focus Group Discussion (FGD) and consensus development approach: waiting time, quality of care, travel time, hospital type, provider competency, and hospital facilities. individuals' preferences for hospital attributes were analyzed using a mixed logit model, and interaction terms were used to assess preference heterogeneity among individuals with different sociodemographic characteristics.

Participants had strong and significant preferences for care delivered in hospitals with 'full' (β = 0.6052, p<0.001) or 'moderate' (β = 0.5882, p<0.001) hospital equipment and with 'excellent' provider competency (β = 0.2637, p<0.001). The estimated coefficients for the "waiting time of 120 minutes" (β = -0.1625, p<0.001) and the "travel time of 30 minutes" (β = -0.1157, p<0.001) were negative and significant. The results also show that the personal characteristics such as age, education level, and income significantly affected individual preferences in choosing a hospital.

Considering people's preferences can be important given the more active role of today's patients in decision-making about their treatment processes. The results of this study should be taken into consideration by health policymakers and all stakeholders to be aware of differences in preferences of people and maximize their satisfaction. In this case, it is important to continuously involve people and consider their preferences in the design, topology, construction, and equipment of hospitals.