What Matters to Potential Patients in Chemotherapy Service Delivery? A Discrete Choice Experiment

Introduction: Designing and funding chemotherapy care to meet patient expectations is challenging. Issues including convenience, outcomes, cost, and continuity of care are all potentially important and the appropriate trade-off between them is not clear. Regions with significant geographic spread and concentration of care in metropolitan areas pose a particular problem as ensuring low-cost convenient care is potentially difficult. However, the relative value of different aspects of chemotherapy are as yet unknown. The objective of this work is to quantify the relative value of different aspects of chemotherapy service delivery in an older Australian general population sample. Methods: A discrete choice experiment was administered in an older Australian general population sample without cancer. The survey approach asks a series of hypothetical choice tasks and allows estimation of the relative value of different aspects of care. Analysis considered the average respondent, and then also explored the level of preference divergence across the population. Results: One thousand and sixty-two individuals provided data and were included in the analysis. There was a strong population preference for home-based chemotherapy, for follow-up by a specialist, for psycho-social support, and for low cost care. Conclusion: These strong population preferences should be considered when designing chemotherapy care. This poses a significant challenge, both logistically and financially. However, this information can help policy makers identify the components of good value care.