青少年口腔正畸方案选择偏好研究——基于离散选择实验
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1.安徽医科大学卫生管理学院;2.安徽医科大学附属口腔医院;3.安徽医科大学卫生管理学院,安徽医科大学卫生政策研究中心;4.安徽医科大学附属口腔医学院;5.麦考瑞大学健康经济学研究中心

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2020年度教育部人文社会科学研究青年基金项目“儿童龋病预防经济学评价及预算影响研究一基于Semi-Markov模型”(基金编号:20YJCZH157)


Preferences for Orthodontic Treatment Options of Teenager Patients :A Discrete Choice Experiment
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1.Stomatological hospital and college, Anhui Medical University;2.Centre for the Health Economy, Macquarie University

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    摘要:

    患方健康偏好对改善服务质量、提高患者满意度具有重要意义。本文旨在定量测量青少年口腔正畸治疗方案的患方选择偏好,为口腔正畸治疗方案精准供给提供参考。基于离散选择实验(DCE)方法,通过文献综述和专家咨询最终纳入研究属性共四个(矫正器美观度、矫正器舒适度、治疗费用、复诊间隔时间)。借助软件Ngene1.2采用D-efficiency设计创建选择集,对安徽省某三级口腔专科医院12~17岁青少年的家长/监护人进行问卷调查。采用条件logit回归模型进行偏好分析。DCE结果显示,除复诊间隔时间外,其他三个研究属性均显著影响正畸方案的选择。治疗费用是影响正畸治疗方案选择最重要的属性,其次是矫正器舒适度和美观度。与舒适度“略差”相比,患方愿意为获得舒适度“非常好”的矫正器多支付2.15万元。将矫正器美观度水平从“略差”提升“非常好”,方案选择概率提高了46.70%。本研究是国内DCE研究在口腔健康领域的首次应用,为其他临床方案决策偏好的推广提供了参考。

    Abstract:

    Patient health preferences are important for improving service quality and satisfaction. The aim of this study is to quantitatively measure patient preference for orthodontic treatment options for adolescents and to provide a reference for the accurate provision of orthodontic treatment options. This study was based on the Discrete Choice Experiment (DCE) method, and a total of four attributes (orthodontic aesthetics, orthodontic comfort, treatment cost, and follow-up interval) were finally included through literature review and expert consultation. A D-efficiency design was used to create a choice set with the aid of the software Ngene 1.2, and a questionnaire survey was conducted with parents/guardians of adolescents aged 12-17 years in a tertiary dental specialist hospital in Anhui Province. A conditional logit regression model was used for preference analysis. DCE results showed that all three study attributes significantly influenced the choice of orthodontic treatment option, with the exception of follow-up interval. Treatment cost was the most important attribute influencing the choice of orthodontic treatment option, followed by orthodontic comfort and aesthetics. Patients were willing to pay ¥21,500 more for a "very good" orthodontic appliance than for a "slightly poor" level of comfort. Increasing the level of appliance aesthetics from "slightly poor" to "very good" increased the probability of choosing a solution by 46.70%. This study is the first application of DCE research in the field of oral health in China and provides a reference for the extension of other clinical options decision preferences.

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  • 收稿日期:2022-03-23
  • 最后修改日期:2022-04-15
  • 录用日期:2022-05-06
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