摘要
目的:系统回顾将离散选择实验(discrete choice experiment,DCE)应用于探讨我国居民家庭医生签约服务需求偏好的相关研究,分析DCE研究设计及研究结果,为优化家庭医生服务及完善DCE设计提供借鉴.方法:系统检索中国知网、万方、维普、PubMed、Web of Science、EMbase等数据库,检索时间限定为2012 年3 月21 日-2023 年3 月10 日.根据纳排标准独立进行文章筛选,并采用PREFS清单评价纳入文献质量.结果:共检索文献148 篇,纳入文献8 篇.PREFS清单显示纳入的DCE研究报告质量较好,但有效人群与无效人群一般特征的差异报告不明.8 篇文献共设置47 个属性,参考各属性定义,将属性分类为成本属性、人员属性、形式属性及内容属性.4 类属性在影响居民签约服务方面均发挥作用,其中人员属性、内容属性分布了居民更偏好的水平.结论:我国居民更偏好高质量服务团队及多样化的服务内容.未来家庭医生签约服务仍需注重提高家庭医生团队水平,并形成组合式服务内容.此外有必要根据服务人群特征深入探讨偏好异质性以提升居民签约意愿.相关DCE研究应充分完善研究设计细节以提供更多高质量证据.
Abstract
Objectives:To systematically review the discrete choice experiment(DCE)applied to the research on the demand preference of Chinese residents for family doctor contracted services,and analyze the research design and results of DCE studies,so as to provide basis and reference for optimizing family doctor services and improving DCE design.Methods:CNKI,Wanfang,VIP,PubMed,Web of Science Core Collection,and EMbase databases was searched from March 21,2012 to March 10,2023.Two researchers independently screened the articles according to the inclusion and exclusion criteria,and the PREFS checklist was used to evaluate the quality of the included articles.Results:A total of 148 articles were retrieved,and 8 articles were included.The PREFS list showed that the reporting quality of the included DCE studies was good,but the differences in general characteristics be-tween the effective and ineffective populations were not reported.A total of 47 attributes were set up in 8 literatures.According to the definition of each attribute,the attribute was classified into cost attribute,personnel attribute,form attribute and content attrib-ute.The four attributes all played a role in determining the needs of residents,among which the human factor and the content factor distributed the levels that the residents preferred.Conclusion:Chinese residents prefer high-quality service teams and diversified service contents.In the future,family doctor contracted services still need to focus on improving the team level of family doctors and reasonable combination of service content.In addition,it is necessary to explore the heterogeneity of preference according to the characteristics of the service population to improve the residents'signing intention.Relevant DCE studies should fully improve the details of study design to provide more high-quality evidence.
基金项目
国家科技部重点研发计划重点专项子课题(2020YFC2008802)
维普
万方数据