article · BMC Health Services Research
Uptake of essential health services remains low in Ethiopia, where patient choices are shaped by specific facility features. A discrete choice experiment surveyed over one thousand outpatient visitors across the Wolaita area to understand what drives hospital selection. Participants evaluated six hospital attributes: healthcare provider competence, availability of medical equipment and supplies, service cost, waiting times, travel distance, and general facility reputation. Statistical modelling revealed that every evaluated attribute significantly influenced hospital choices. However, marginal willingness to pay and preference analyses demonstrated that healthcare provider competence was the single most decisive factor for patients, followed closely by the availability of necessary medical supplies and equipment. The findings indicate that hospital usage could be effectively boosted by targeting professional clinical training alongside improvements to supply chain and inventory management.
When patients avoid or delay hospital visits, vital medical interventions are missed. Knowing precisely which hospital characteristics patients care about most allows health authorities and hospital managers to focus limited resources effectively. Prioritising staff skills and stocking essential medical supplies directly addresses patient priorities, which can raise healthcare uptake and improve community health outcomes.
This research provides applied survey evidence that could inform healthcare administrators, policymakers, and providers of clinical training or hospital supply chain management systems. Although the study does not present a direct commercial product, the findings identify immediate operational priorities, such as staff assessment tools and inventory monitoring mechanisms, that could guide healthcare service improvements and procurement strategies in regional health facilities.
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BACKGROUND: Patient preference has preceded the use of health care services, and it has been affected by different hospital attributes. Meanwhile, the number of patients receiving vital health intervention is particularly low in Ethiopia. Therefore, this study aimed to determine the effect of hospital attributes on patient preference for outpatients in the Wolaita area in September 2020. METHODS: A discrete choice experimental study was applied to determine the effect of hospital attributes on patient preference with a sample size of 1077. The experimental survey was conducted among outpatient attendants selected through a systematic random sampling approach. Six key attributes (competence of healthcare providers; availability of medical equipment and supplies; cost of service; wait time; distance; and hospital reputation) deduced from various hospital attributes were used to elicit the patient preferences. The data was collected from participants through the Open Data Kit application. A random effect probit model with marginal willingness to pay measure and partially log-likelihood analysis was applied to extract important attributes. We used STATA version 15 software for analysis, and the fitness of the model was verified by the calculated p-value for the Wald chi-square with a cut-point value of 0.05. RESULT: One thousand forty-five patients who received outpatient care participated in the study. The random effect probit results have shown that all hospital attributes included in the study were significantly valued by patients while choosing the hospital (p-value < 0.001). Meanwhile, based on marginal willingness to pay and partial log-likelihood analysis, the competence of health care providers was identified as the most important attribute followed by the availability of medical equipment and supplies in hospitals. CONCLUSION AND RECOMMENDATION: The results suggested that the quality of health care providers and availability of medical equipment and supply in hospitals would be primary interventional points for improving the patient preference of hospitals. Assessment, education, and training are recommended for enhancing the quality of health care providers. And stock balance checks, inspections, and accreditation are believed to be valuable for improving the availability of equipment and supply in hospitals.
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DOI: 10.1186/s12913-022-07874-x
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