Assessment of patient preferences for assisted reproductive technology in China: a discrete choice experiment
Objectives Given China’s low fertility rate, assisted reproductive technology (ART) can be used assist infertile patients in having children. This study aimed to analyse patients’ preferences for ART and to determine the relative importance (RI) and willingness to pay (WTP) of key attributes.Design...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/2/e090140.full |
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| author | Lingli Zhang Xin Li Jiali Chen Yanyan Liu Yanjun Sun Yuwen Bao Xiaodan Qian Kexing Fang Bin Wan Haixia Ding |
| author_facet | Lingli Zhang Xin Li Jiali Chen Yanyan Liu Yanjun Sun Yuwen Bao Xiaodan Qian Kexing Fang Bin Wan Haixia Ding |
| author_sort | Lingli Zhang |
| collection | DOAJ |
| description | Objectives Given China’s low fertility rate, assisted reproductive technology (ART) can be used assist infertile patients in having children. This study aimed to analyse patients’ preferences for ART and to determine the relative importance (RI) and willingness to pay (WTP) of key attributes.Design We identified six attributes of ART and used a D-efficient design to generate choice sets for conducting a discrete choice experiment. Patients were asked to choose between two scenarios that differed in participation in treatment decision-making (TDM), clinical pregnancy rate, live birth rate, risk of maternal and neonatal complications, and out-of-pocket cost.Setting Jiangsu province, China. The anonymous survey was carried out between December 2022 and February 2023.Participants Female patients aged 20–45 years, with low fertility or experience of ART treatment. We recruited 465 participants.Outcomes measures Patient-reported preferences for each attribute were estimated using a mixed logit model. The latent class model was also used to investigate preference heterogeneity.Results All attributes were associated with patient preferences. Patients considered the live birth rate as the most important attribute (RI=29.05%), followed by participation in TDM (RI=21.91%). The latent class model revealed two distinct classes named ‘outcome driven’ and ‘cost driven’. Preferences varied according to their age, monthly household income and location.Conclusions This study investigated the preferences of infertile patients when seeking medical assistance for infertility. The study outcomes can contribute to evidence-based counselling and shared decision-making and provide an empirical basis for creating and implementing future policies. |
| format | Article |
| id | doaj-art-33860115a6bf4afeb5387bf5332803ed |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-33860115a6bf4afeb5387bf5332803ed2025-02-04T04:50:08ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2024-090140Assessment of patient preferences for assisted reproductive technology in China: a discrete choice experimentLingli Zhang0Xin Li1Jiali Chen2Yanyan Liu3Yanjun Sun4Yuwen Bao5Xiaodan Qian6Kexing Fang7Bin Wan8Haixia Ding9School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, ChinaDepartment of Health Policy, Nanjing Medical University, Nanjing, Jiangsu, ChinaDepartment of Health Policy, Nanjing Medical University, Nanjing, Jiangsu, ChinaDepartment of Health Policy, Nanjing Medical University, Nanjing, Jiangsu, ChinaInstitute of Medical Humanities, Nanjing Medical University, Nanjing, ChinaDepartment of Health Policy, Nanjing Medical University, Nanjing, Jiangsu, ChinaDepartment of Pharmacy, The Second People`s Hospital of Changzhou, the Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USADepartment of Health Insurance Management, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu, ChinaSchool of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, ChinaObjectives Given China’s low fertility rate, assisted reproductive technology (ART) can be used assist infertile patients in having children. This study aimed to analyse patients’ preferences for ART and to determine the relative importance (RI) and willingness to pay (WTP) of key attributes.Design We identified six attributes of ART and used a D-efficient design to generate choice sets for conducting a discrete choice experiment. Patients were asked to choose between two scenarios that differed in participation in treatment decision-making (TDM), clinical pregnancy rate, live birth rate, risk of maternal and neonatal complications, and out-of-pocket cost.Setting Jiangsu province, China. The anonymous survey was carried out between December 2022 and February 2023.Participants Female patients aged 20–45 years, with low fertility or experience of ART treatment. We recruited 465 participants.Outcomes measures Patient-reported preferences for each attribute were estimated using a mixed logit model. The latent class model was also used to investigate preference heterogeneity.Results All attributes were associated with patient preferences. Patients considered the live birth rate as the most important attribute (RI=29.05%), followed by participation in TDM (RI=21.91%). The latent class model revealed two distinct classes named ‘outcome driven’ and ‘cost driven’. Preferences varied according to their age, monthly household income and location.Conclusions This study investigated the preferences of infertile patients when seeking medical assistance for infertility. The study outcomes can contribute to evidence-based counselling and shared decision-making and provide an empirical basis for creating and implementing future policies.https://bmjopen.bmj.com/content/15/2/e090140.full |
| spellingShingle | Lingli Zhang Xin Li Jiali Chen Yanyan Liu Yanjun Sun Yuwen Bao Xiaodan Qian Kexing Fang Bin Wan Haixia Ding Assessment of patient preferences for assisted reproductive technology in China: a discrete choice experiment BMJ Open |
| title | Assessment of patient preferences for assisted reproductive technology in China: a discrete choice experiment |
| title_full | Assessment of patient preferences for assisted reproductive technology in China: a discrete choice experiment |
| title_fullStr | Assessment of patient preferences for assisted reproductive technology in China: a discrete choice experiment |
| title_full_unstemmed | Assessment of patient preferences for assisted reproductive technology in China: a discrete choice experiment |
| title_short | Assessment of patient preferences for assisted reproductive technology in China: a discrete choice experiment |
| title_sort | assessment of patient preferences for assisted reproductive technology in china a discrete choice experiment |
| url | https://bmjopen.bmj.com/content/15/2/e090140.full |
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