Dataset Information

What do Iranian physicians value most when choosing a specialty? Evidence from a discrete choice experiment.

ABSTRACT:

Background

Choosing a specialty by physicians is fundamentally linked to the performance of health systems and public health outcomes. Identifying the determinants of specialty selection is important to health policy for targeting resources and planning the development of services. This study examined preferences of Iranian physicians for medical specialty using a discrete choice experiment (DCE) method.

Methods

In this study, the attributes of the DCE were determined using rigorous qualitative approach. Then we applied D-efficiency criteria to design the DCE and validated it at a pilot study. In the final survey, we recruited participants from six Iranian provinces and analyzed data using conditional logit model. We estimated willingness to pay (WTP) for non-monetary attributes.

Results

The WTP analysis revealed that the most important non-monetary attributes in the selection of a specialty were job burnout, opportunity for procedural activities, and job prestige. The results imply that the attributes that were related to the quality of personal life was more important only for physicians who preferred to choose non-surgical specialties.

Conclusions

The findings demonstrate that traditional gender patterns of specialty selection are changing and quality of personal life characteristics might be the most important factor when developing policies to recruit physicians into non-surgical specialties.

SUBMITTER: Sarikhani Y

PROVIDER: S-EPMC9134140 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

What do Iranian physicians value most when choosing a specialty? Evidence from a discrete choice experiment.

Sarikhani Yaser Y Ghahramani Sulmaz S Edirippulige Sisira S Fujisawa Yoshikazu Y Bambling Matthew M Bastani Peivand P

Cost effectiveness and resource allocation : C/E 20220526 1

<h4>Background</h4>Choosing a specialty by physicians is fundamentally linked to the performance of health systems and public health outcomes. Identifying the determinants of specialty selection is important to health policy for targeting resources and planning the development of services. This study examined preferences of Iranian physicians for medical specialty using a discrete choice experiment (DCE) method.<h4>Methods</h4>In this study, the attributes of the DCE were determined using rigoro ...[more]

PMID: 35619135

Similar Datasets

Project description:Objectives: To survey, analyze, and ascertain the preferences for specialty pharmacy services among patients requiring complex care and to provide evidence to support specialty pharmacy service decision-making in China. Methods: To identify essential service attributes and levels, a review of the literature, discussions with specialty pharmacy managers and a pilot questionnaire were conducted. A D-efficient fractional factorial design was used to generate the discrete-choice experiment (DCE) questionnaire. A face-to-face survey of patients with chronic illness and their families or friends was conducted at three specialty pharmacies in Chengdu and Qingdao, China. A mixed logit model was used for estimation. Results: Six relevant attributes were identified and incorporated into the DCE questionnaire. A total of 417 participants completed the survey (mean age 43 years, 45.1% males), and 32.1% had lung cancer. The conditional relative importance showed that the most critical attribute was "frequency of telephone follow-up to monitor adverse drug reactions (ADRs), "followed by "mode of drug delivery," "provider of medication guidance services," and "availability of medical insurance consultation"; the least important attribute was "business hours." A 1 min increase in time spent led to a 0.73% decrease in the probability that a service profile would be chosen. Negative preferences were noted for ADR monitoring by telephone follow-up once a year (β = -0.23, p < 0.001) and business hours [8:30-20:00 (Monday to Friday), 8:30-17:30 (weekend)] (β = -0.12, p < 0.001). Compared with women, men had a higher preference for service monitoring ADRs once every 3 months. Conclusions: Preference measurements showed that "frequency of telephone follow-up to monitor ADRs" had the most critical impact on decisions, followed by "mode of drug delivery." Specialty pharmacies in China need to take these findings into account to improve their design to increase uptake and patient loyalty.

Project description:BackgroundRetaining specialist physicians in rural parts of India poses a fundamental challenge, which affects the health care system's functionality and provision of standard health care services. There has been an acute shortfall of specialist physicians in the fields of medicine, pediatrics, obstetrics and gynecology, and surgery at rural community health centers. This necessitates urgent policy focus to address the shortages and design effective rural retention strategies. In this study, which uses a discrete choice experiment (DCE), individuals choose from multiple-choice preferences that resemble hypothetical job descriptions.ObjectiveDCEs are a quantitative approach to assessing several aspects of job selection. This study aims to develop a detailed plan of a DCE method used to determine specialist physicians' job choices. This protocol outlines the DCE method, which uses an exploratory sequential mixed methods research design to understand specialist physicians' preferences and design reward packages that would effectively motivate them to work in underserved regions.MethodsThe qualitative phase of the study involved identifying job attributes and their corresponding levels for the DCE. We followed a meticulous process, which included reviewing relevant literature, performing qualitative pilot work, conducting in-depth individual interviews, and consulting with medical and health experts. The quantitative phase involved generating a D-efficient orthogonal fractional factorial design using Ngene software to create choice scenarios using the identified job factors and their corresponding levels. The generated choice scenarios were blocked into 6 versions in 6 blocks. The DCE was undertaken among final-year postgraduate medical residents and specialist physicians from several health care facilities in Rajasthan. Various statistical models will be applied to explore the response variability and quantify the trade-offs that participants are willing to make for nonmonetary features as a substitute for adjustments in the monetary attribute.ResultsAfter the ethics committee's approval of the study, the qualitative data collection phase occurred from September to December 2021, while the quantitative phase took place from May to August 2022. Six attributes and 14 levels were identified and established through qualitative surveys. The experimental design resulted in 36 choice situations, which were grouped into 6 blocks. The preliminary investigation demonstrated that the instrument was valid and reliable. Statistical data analysis has been initiated, and the principal findings are expected to be disseminated in January 2025.ConclusionsThe protocol provides a systematic framework to assess specialist physicians' preferences regarding working in rural health care centers. This research has the potential to substantially influence the future of rural health care by laying the foundation for understanding specialist physicians' choices, which will help design future incentive schemes, policy interventions, and research.International registered report identifier (irrid)DERR1-10.2196/59621.

Project description:IntroductionSelf-injectable calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb) auto-injectors and non-CGRP oral medications are currently available for migraine prevention in Japan. This study elicited the preferences for self-injectable CGRP mAbs and non-CGRP oral medications and determined differences in the relative importance of auto-injector attributes for patients and physicians in Japan.MethodsJapanese adults with episodic (EM) or chronic (CM) migraine and physicians who treat migraine completed an online discrete choice experiment (DCE), asking participants to choose a hypothetical treatment they preferred between two self-injectable CGRP mAb auto-injectors and a non-CGRP oral medication. The treatments were described by seven treatment attributes, with attribute levels varying between questions. DCE data were analyzed using a random-constant logit model to estimate relative attribution importance (RAI) scores and predicted choice probabilities (PCP) of CGRP mAb profiles.ResultsA total of 601 patients (79.2% with EM, 60.1% female, mean age: 40.3 years) and 219 physicians (mean length of practice: 18.3 years) completed the DCE. About half (50.5%) of patients favored CGRP mAb auto-injectors, while others were skeptical of (20.2%) or averse (29.3%) to them. Patients most valued needle removal (RAI = 33.8%), shorter injection duration (RAI = 32.1%), and auto-injector base shape and need for skin pinching (RAI = 23.2%). Most physicians (87.8%) favored auto-injectors over non-CGRP oral medications. Physicians most valued less-frequent dosing RAI = 32.7%), shorter injection duration (30.4%), and longer storage outside the fridge (RAI = 20.3%). A profile comparable to galcanezumab showed a higher likelihood of being chosen by patients (PCP = 42.8%) than profiles comparable to erenumab (PCP = 28.4%) and fremanezumab (PCP = 28.8%). The PCPs of the three profiles were similar among physicians.ConclusionMany patients and physicians preferred CGRP mAb auto-injectors over non-CGRP oral medications and preferred a treatment profile similar to galcanezumab. Our results may encourage physicians in Japan to consider patient preferences when recommending migraine preventive treatments.

Project description:BackgroundGuidelines include several options for average-risk colorectal cancer (CRC) screening that vary in aspects such as invasiveness, recommended frequency, and precision. Thus, patient and provider preferences can help identify an appropriate screening strategy. This study elicited CRC screening preferences of physicians and individuals at average risk for CRC (IAR).MethodsIAR aged 45-75 years and licensed physicians (primary care or gastroenterology) completed an online discrete choice experiment (DCE). Participants were recruited from representative access panels in the US. Within the DCE, participants traded off preferences between screening type, screening frequency, true-positive, true-negative, and adenoma true positive (physicians only). A mixed logit model was used to obtain predicted choice probabilities for colonoscopy, multi-target stool DNA (mt-sDNA), fecal immunochemical test (FIT), and methylated septin 9 (mSEPT9) blood test.ResultsPreferences of IAR and physicians were affected by screening precision and screening type. IAR also valued more regular screening. Physicians preferred colonoscopy (96.8%) over mt-sDNA (2.8%; p < 0.001), FIT (0.3%; p < 0.001) and mSEPT9 blood test (0.1%; p < 0.01). IAR preferred mt-sDNA (38.8%) over colonoscopy (32.5%; p < 0.001), FIT (19.2%; p < 0.001), and mSEPT9 blood test (9.4%; p < 0.001). IAR naïve to screening preferred non-invasive screening (p < 0.001), while the opposite was found for those who previously underwent colonoscopy or sigmoidoscopy.ConclusionsWhile physicians overwhelmingly preferred colonoscopy, preferences of IAR were heterogenous, with mt-sDNA being most frequently preferred on average. Offering choices in addition to colonoscopy could improve CRC screening uptake among IAR. This study used a discrete choice experiment in the US to elicit preferences of physicians and individuals at average risk for colorectal cancer screening modalities and their characteristics.

Dataset Information

What do Iranian physicians value most when choosing a specialty? Evidence from a discrete choice experiment.

Background

Methods

Results

Conclusions

Publications

What do Iranian physicians value most when choosing a specialty? Evidence from a discrete choice experiment.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets