General population preferences for cancer care in health systems of China: A discrete choice experiment

Background: The increasing incidence of cancer in China has posed considerable challenges for cancer care delivery systems. This study aimed to determine the general population's preferences for cancer care, to provide evidence for building a people-centered integrated cancer care system. Methods: We conducted a discrete choice experiment that involved 1,200 participants in Shandong Province. Individuals were asked to choose between cancer care scenarios based on the type and level of hospitals, with various out-of-pocket costs, waiting time, and contact working in the hospitals. Individual preferences, willingness to pay, and uptake rate were estimated using a mixed-logit model. Results: This study included 848 respondents (70.67%). Respondents preferred county hospitals with shorter hospitalization waiting times and contact working in hospitals. Compared to the reference levels, the three highest willingness to pay values were related to waiting time for hospitalization ( yen 97,857.69- yen 145411.70- yen 212,992.10/$14512.70-$21565.16-$31587.61), followed by the county-level hospital ( yen 32,545.13/$4826.58). The preferences of the different groups of respondents were diverse. Based on a county-level general hospital with contact in the hospital, 50% out-of-pocket costs and a waiting time of 15 days, the probability of seeking baseline care was 0.37. Reducing the waiting time from 15 to 7, 3, and 0 days, increases the probability of choosing a county-level hospital from 0.37 to 0.58, 0.64, and 0.70, respectively. Conclusions: This study suggests that there is a substantial interest in attending county-level hospitals and that reducing hospitalization waiting time is the most effective measure to increase the probability of seeking cancer care in county-level hospitals.