Preferences for pulmonary rehabilitation care: a discrete choice experiment among patients

Background: Preferences of patients are important to design optimal rehabilitation care. This study analyzes preferences for rehabilitation care among patients who have undergone or are still following rehabilitation and patients who have not (yet) received rehabilitation. We use data for a country where pulmonary rehabilitation is still underdeveloped. Methods: A discrete choice experiment (DCE)was carried out where patients were asked to choose repeatedly between two hypothetical rehabilitation care packages with seven different attributes:attitude of the staff,travel time to the clinic,out-of-pocket costs,medical equipment,rehabilitation plan,additional lifetsyle education session and support during rehabilitation care. Preference heterogeneity among patients with different person and disease-related characteristics was investigated using random effect binary logistic regression. Regressions were run for all the respondents,as well as for users and non-users separetly, to identify significant associations. Results: In total,126 respondents fully completed the DCE questions. The most preferred attribute was an informal and friendly attitude of the staff followed by modern equipment,additional lifestyle education session via eHealth and support during the rehabilitation. Respondents were less in favor of going to a clinic and paying additional out-of pocket cost for the rehabilitation. This rank-order was similar between users and non-users. Conclusion: In the design of rehabilitation programs,the importance of the attribute in the treatment plan need to be considered. Improving patient experience with rehabilitation by giving the best care based on a patient centered-approach is essential.