Analysis on Care Service Preferences of Community Patients With Severe Mental Disorders in Beijing Based on Discrete Choice Experiment

Jinqi ZHU, Wei LU, Yu XIN, Yun CHEN, Qingzhi HUANG, Junli ZHU

Acta Academiae Medicinae Sinicae ›› 2025, Vol. 47 ›› Issue (3) : 425-433.

PDF(882 KB)
Home Journals Acta Academiae Medicinae Sinicae
Acta Academiae Medicinae Sinicae

Abbreviation (ISO4): Acta Academiae Medicinae Sinicae      Editor in chief: Xuetao CAO

About  /  Aim & scope  /  Editorial board  /  Indexed  /  Contact  / 
PDF(882 KB)
Acta Academiae Medicinae Sinicae ›› 2025, Vol. 47 ›› Issue (3) : 425-433. DOI: 10.3881/j.issn.1000-503X.16281
Original Articles

Analysis on Care Service Preferences of Community Patients With Severe Mental Disorders in Beijing Based on Discrete Choice Experiment

Author information +
History +

Abstract

Objective To gain insights into the care service preferences and willingness of patients with severe mental disorders in Beijing,analyze the main factors affecting their participation in care services,and provide data support and decision-making reference for the optimal design of care services for patients with severe mental disorders and the improvement of relevant policies.Methods In July 2022,a questionnaire survey was conducted for a part of Beijing community patients with severe mental disorders selected by multi-stage stratified sampling,including the basic personal information and the preferences of discrete choice experiment.A mixed Logit model was used to perform regression analysis on the care service preferences,and the trade off between general and monetary attributes was quantified by willingness to pay(WTP).Results A total of 242 questionnaires were distributed,and 181 valid questionnaires were collected,with a response rate of 74.79%.The regression coefficients for the four attributes—service type,service content,service frequency,and service cost—all showed statistical significance(all P<0.05).Patients’ most preferred attribute level was a service frequency covering about 90% of the time per month/year(β=1.059),while the least preferred was full-time residential care(β=-1.025).Increasing the service frequency from 30% to 90% corresponded to a WTP of 492.5 yuan,while changing the service type from home-based care to full-time residential care resulted in a WTP of -476.6 yuan.Moreover,there were differences in care service preferences and WTP among patient groups with different characteristics(all P<0.05).Conclusions Service type,service content,service frequency,and service cost all significantly affect the care service preferences of patients with severe mental disorders.There is heterogeneity in care service preferences among patient groups with different characteristics.

Key words

discrete choice experiment / severe mental disorder / care service / preference

Cite this article

Download Citations
Jinqi ZHU , Wei LU , Yu XIN , et al . Analysis on Care Service Preferences of Community Patients With Severe Mental Disorders in Beijing Based on Discrete Choice Experiment[J]. Acta Academiae Medicinae Sinicae. 2025, 47(3): 425-433 https://doi.org/10.3881/j.issn.1000-503X.16281

References

[1]
钟玉英. “健康中国战略”下社区精神健康服务协同供给的实现框架及路径[J]. 中国卫生政策研究, 2020, 13(8):8-14.DOI:10.3969/j.issn.1674-2982.2020.08.002.
[2]
Xu J, Wang J, Wimo A, et al. The economic burden of mental disorders in China,2005-2013:implications for health policy[J]. BMC Psychiatry, 2016,16:137.DOI:10.1186/s12888-016-0839-0.
[3]
Ma H. Integration of hospital and community services—the‘686 Project’—is a crucial component in the reform of China’s mental health services[J]. Shanghai Arch Psychiatry, 2012, 24(3):172-174.DOI:10.3969/j.issn.1002-0829.2012.03.008.
[4]
李进, 肖雨桐, 付文彬, 等. 湖南省严重精神障碍患者肇事肇祸行为的影响因素分析[J]. 国际精神病学杂志, 2021, 48(2):237-240,274.DOI:10.13479/j.cnki.jip.2021.02.013.
[5]
Chien WT, Chan SWC, Morrissey J. The perceived burden among Chinese family caregivers of people with schizophrenia[J]. J Clin Nurs, 2007, 16(6):1151-1161.DOI:10.1111/j.1365-2702.2007.01501.x.
[6]
Kumagai N. Distinct impacts of high intensity caregiving on caregivers’ mental health and continuation of caregiving[J]. Health Econ Rev, 2017, 7(1):15.DOI:10.1186/s13561-017-0151-9.
[7]
Estrada-Fernandez ME, Gil-Lacruz M, Gil-Lacruz AI, et al. The impact of community care:burden and quality of life of the informal caregivers of patients with severe mental disorder[J]. J Community Psychol, 2022, 50(1):487-501.DOI:10.1002/jcop.22594.
[8]
Yesufu-Udechuku A, Harrison B, Mayo-Wilson E, et al. Interventions to improve the experience of caring for people with severe mental illness:systematic review and meta-analysis[J]. Br J Psychiatry, 2015, 206(4):268-274.DOI:10.1192/bjp.bp.114.147561.
[9]
Henderson C, Evans-Lacko S, Thornicroft G. Mental illness stigma,help seeking,and public health programs[J]. Am J Public Health, 2013, 103(5):777-780.DOI:10.2105/AJPH.2012.301056.
[10]
Bridges JFP, Kinter ET, Schmeding A, et al. Can patients diagnosed with schizophrenia complete choice-based conjoint analysis tasks[J]. Patient, 2011, 4(4):267-275.DOI:10.2165/11589190-000000000-00000.
[11]
de Bekker-Grob EW, Donkers B, Jonker MF, et al. Sample size requirements for discrete-choice experiments in healthcare:a practical guide[J]. Patient, 2015, 8(5):373-384.DOI:10.1007/s40271-015-0118-z.
[12]
Soekhai V, de Bekker-Grob EW, Ellis AR, et al. Discrete choice experiments in health economics:past,present and future[J]. Pharmacoeconomics, 2019, 37(2):201-226.DOI:10.1007/s40273-018-0734-2.
[13]
de Bekker-Grob EW, Ryan M, Gerard K. Discrete choice experiments in health economics:a review of the literature[J]. Health Econ, 2012, 21(2):145-172.DOI:10.1002/hec.1697.
[14]
Thornicroft G, Tansella M. The balanced care model for global mental health[J]. Psychol Med, 2013, 43(4):849-863.DOI:10.1017/S0033291712001420.
[15]
Thornicroft G, Tansella M. Balancing community-basedand hospital-based mental health care[J]. World Psychiatry, 2002, 1(2):84-90.
[16]
民政部等四部门印发《关于加快精神障碍社区康复服务发展的意见》[J]. 中国民政, 2017(22): 45.DOI:10.3969/j.issn.1002-4441.2017.22.027.
[17]
江苏省民政厅. 力推精神障碍社区康复服务的江苏探索[J]. 社会福利, 2022(11):11-13.
[18]
Millier A, Schmidt U, Angermeyer MC, et al. Humanistic burden in schizophrenia:a literature review[J]. J Psychiatr Res, 2014, 54:85-93.DOI:10.1016/j.jpsychires.2014.03.021.
[19]
Alyafei AH, Alqunaibet T, Mansour H, et al. The experiences of family caregivers of people with severe mental illness in the Middle East:a systematic review and meta-synthesis of qualitative data[J]. PLos One, 2021, 16(7):e0254351.DOI:10.1371/journal.pone.0254351.
[20]
陈春梅, 马宁, 朱益. 上海市社区精神卫生人力资源调查[J]. 预防医学, 2019, 31(5):534-536.DOI:10.19485/j.cnki.issn2096-5087.2019.05.028.
[21]
林函伊, 王伟, 张伟波, 等. 精神障碍社区康复服务国际经验与启示[J]. 中国初级卫生保健, 2023, 37(9):8-11.DOI:10.3969/j.issn.1001-568X.2023.09.0003.
[22]
Moreno C, Wykes T, Galderisi S, et al. How mental health care should change as a consequence of the COVID-19 pandemic[J]. Lancet Psychiatry, 2020, 7(9):813-824.DOI:10.1016/S2215-0366(20)30307-2.
[23]
严芳, 姚丰菊, 李拴荣, 等. 同伴支持在社区精神分裂症患者中的应用[J]. 中华护理杂志, 2019, 54(10):1545-1550.DOI:10.3761/j.issn.0254-1769.2019.10.020.
[24]
翟倩, 胡昌清, 杨丽, 等. 社会支持情况与精神障碍相关性研究[J]. 首都医科大学学报, 2018, 39(5):646-650.DOI:10.3969/j.issn.1006-7795.2018.05.005.
[25]
陈琼妮, 刘莉, 张丹, 等. 社会支持对精神分裂症患者生活质量和康复的影响[J]. 中国临床心理学杂志, 2016, 24(1):185-187.DOI:10.16128/j.cnki.1005-3611.2016.01.043.
[26]
Van Bortel T, Wickramasinghe ND, Treacy S, et al. Anticipated and experienced stigma and discrimination in the workplace among individuals with major depressive disorder in 35 countries:qualitative framework analysis of a mixed-method cross-sectional study[J]. BMJ Open, 2024, 14(6):e077528.DOI:10.1136/bmjopen-2023-077528.
[27]
Khalaf Beigi M, Mohammadi Shahbolaghi F, Rassafiani M, et al. The meaning of work in people with severe mental illness(SMI)in Iran[J]. Med J Islam Repub Iran, 2015,29:179.
[28]
魏李芳, 张玲, 谭娅, 等. 慢性病共病患者社区卫生服务的选择偏好研究[J]. 中国全科医学, 2024, 27(4):454-459,467.DOI:10.12114/j.issn.1007-9572.2023.0345.
[29]
蒋妍妍, 谷俊朝, 王虎峰. 基于离散选择实验的居民家庭医生签约服务偏好研究[J]. 卫生经济研究, 2024, 41(3):36-40,46.DOI:10.14055/j.cnki.33-1056/f.2024.03.014.
[30]
Tamizi Z, Fallahi-Khoshknab M, Dalvandi A, et al. Caregiving burden in family caregivers of patients with schizophrenia:a qualitative study[J]. J Educ Health Promot, 2020,9:12.DOI:10.4103/jehp.jehp_356_19.
[31]
万霞, 庞亚娟, 周兰姝. 上海市老年家庭护理服务支付意愿[J]. 中国老年学杂志, 2017, 37(11):2814-2816.DOI:10.3969/j.issn.1005-9202.2017.11.097.
[32]
陈云, 黄庆之, 许莹, 等. 北京市严重精神障碍患者免费服药现况分析及展望[J]. 公共卫生与预防医学, 2021, 32(5):15-19.DOI:10.3969/j.issn.1006-2483.2021.05.004.
[33]
翁飞潇, 吴宏洛. 基于老年女性养老需求的福利供给探析[J]. 中共福建省委党校学报, 2017(1):91-98.DOI:10.15993/j.cnki.cn35-1198/c.2017.01.010.
[34]
Otten D, Tibubos AN, Schomerus G, et al. Similarities and differences of mental health in women and men:a systematic review of findings in three large German cohorts[J]. Front Public Health, 2021,9:553071.DOI:10.3389/fpubh.2021.553071.
[35]
白桂莲, 申铁华, 魏娟. 脑卒中患者主要照顾者负担与社会支持的相关性分析[J]. 宁夏医学杂志, 2013, 35(12):1280-1282.DOI:10.13621/j.1001-5949.2013.12.069.
PDF(882 KB)

Accesses

Citation

Detail

Sections
Recommended

/