Patient Preferences for Public and Private Diabetes Care: A Discrete Choice Experiment Study in Vietnam

This study explores which aspects of service provision individuals living with diabetes most value when choosing between private and public healthcare providers, building on previous preference research that consistently highlights the importance of cost, access, and continuity of care in shaping diabetes care decisions.

A discrete choice experiment was administered to 194 adults with diabetes. Attributes were developed through qualitative interviews and stakeholder validation. Six attributes were included: appointment scheduling, the ability to choose a doctor, examination quality, the doctor's attitude, medication availability, and insurance coverage. A D-efficient design was generated using Stata; data were analyzed using panel conditional logit models.

The patients significantly valued flexible appointment times, the ability to choose a doctor for treatment, quality of examination and attention to diabetes-related problems such as insomnia, fatigue, and anxiety, and insurance coverage for treatment costs. If the treatment costs in private providers were covered by public health insurance, the probability of patients choosing these providers would increase by 30.5%, 95% CI [26.0%, 34.8%]. Similarly, the probabilities of patients choosing private providers would increase by 19.2%, 6.5%, and 5.9% if there were improvements in the quality of examinations, the ability to choose a doctor, and flexible appointment times, respectively.

The study highlights the service attributes most valued by people with diabetes and provides actionable evidence for improving the responsiveness of both public and private care. These findings can inform future deliberations on service design to better align care delivery with patient preferences.