Preferences of patients with chronic obstructive pulmonary disease for online nursing consultation services: a discrete choice experiment

IF 8.1 1区医学 Q1 HEALTH CARE SCIENCES & SERVICES The Lancet Regional Health: Western Pacific Pub Date : 2025-02-01 DOI:10.1016/j.lanwpc.2024.101382

Juan He , Xiaoqian Xia , Jingbo Zhang , Niuniu Sun , Jiangfan Ma , Ping Yang , Chang Wu , Yang Ni , Yibo Wu

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Abstract

Background

Chronic obstructive pulmonary disease (COPD) imposes a significant burden on patients and society, and the majority of COPD patients in China manage their condition at home long-term but often fail to achieve the desired outcomes. Online nursing consultation services (ONCS) are an effective intervention to help patients improve their disease prognosis. In recent years, artificial intelligence (AI) technology has garnered considerable attention. Medical institutions in China are exploring and planning ONCS combined with AI, and this study aims to understand the preferences and willingness to pay for ONCS among COPD patients.

Methods

We surveyed 224 COPD patients in Luoyang City, China, collecting their demographic information and responses to a discrete choice experiment (DCE) involving five attributes: service provider, response time, response accuracy, service content, and service cost.

Findings

The results revealed that COPD patients favoured ONCS provided by a combination of nurses and AI as service providers (β = 0.36), preferred faster response time (β = 3.38), higher response accuracy (β = 1.74), and chronic nursing as the service content (β = 0.92), all while expecting lower service costs. The relative importance (RI) of these attributes was distributed as 18.1%, 21.4%, 19.2%, 28.7%, and 12.6%, respectively. Specifically, participants were willing to pay an additional ¥22.3 for a shift from nurses to a combination of nurses and AI, ¥2.3 more for each minute reduction in response time, ¥1.5 more for every 1% increase in response accuracy, and ¥57.1 more for a shift from health education to chronic nursing.

Interpretation

This study thoroughly investigated COPD patients' preferences for ONCS. The findings offer valuable insights for optimizing these services. The findings suggest that healthcare organizations should actively integrate services that combine nurses and AI in order to reduce response time, enhance accuracy, effectively support chronic disease management, and minimise service costs.

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慢性阻塞性肺疾病患者对在线护理咨询服务的偏好：离散选择实验

慢性阻塞性肺疾病（COPD）给患者和社会带来了巨大的负担，中国大多数COPD患者长期在家治疗，但往往无法达到预期的结果。在线护理咨询服务（ONCS）是帮助患者改善疾病预后的有效干预手段。近年来，人工智能（AI）技术引起了相当大的关注。中国的医疗机构正在探索和规划ONCS与人工智能的结合，本研究旨在了解COPD患者对ONCS的偏好和支付意愿。方法对洛阳市224例慢性阻塞性肺病患者进行调查，收集其人口学信息和对离散选择实验（DCE）的回答，包括服务提供者、反应时间、反应准确性、服务内容和服务成本五个属性。结果显示，COPD患者更倾向于护士与人工智能联合提供的ONCS服务（β = 0.36）、更快的响应时间（β = 3.38）、更高的响应准确性（β = 1.74）和以慢性护理为服务内容（β = 0.92），同时期望更低的服务成本。这些属性的相对重要性（RI）分别为18.1%、21.4%、19.2%、28.7%和12.6%。具体来说，参与者愿意为从护士转向护士和人工智能的组合支付额外的22.3日元，每减少一分钟的反应时间多支付2.3日元，每增加1%的反应准确性多支付1.5日元，从健康教育转向慢性护理多支付57.1日元。本研究深入调查了COPD患者对ONCS的偏好。这些发现为优化这些服务提供了有价值的见解。研究结果表明，医疗机构应积极整合护士和人工智能相结合的服务，以缩短响应时间，提高准确性，有效支持慢性病管理，并最大限度地降低服务成本。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health

CiteScore

8.80

自引率

2.80%

发文量

305

审稿时长

11 weeks

期刊介绍： The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.