Parent's preferences for unscheduled paediatric healthcare: A discrete choice experiment

Background: Unscheduled healthcare is a key component of healthcare delivery and makes up a significant proportion of healthcare access, with children being particularly high users of unscheduled healthcare. Understanding the relative importance of factors that influence this behaviour and decision-making is fundamental to ensuring the system is best designed to meet the needs of users and foster appropriate cost-effective usage of health system resources. Objective: The aim of the study was to identify the parent's preferences for unscheduled healthcare for a common mild childhood illness. Design: A discrete choice experiment (DCE) was developed to identify the preferences of parents accessing unscheduled healthcare for their children. Setting and Participants: Data were collected from parents in Ireland (N = 458) to elicit preferences across five attributes: timeliness, appointment type, healthcare professional attended, telephone guidance before attending and cost. Results: Using a random parameters logit model, all attributes were statistically significant, cost (β = −5.064, 95% confidence interval, CI [−5.60, −4.53]), same-day (β = 1.386, 95% CI [1.19, 1.58]) or next-day access (β = 0.857, 95% CI [0.73, 0.98]), coupled with care by their own general practitioner (β = 0.748, 95% CI [0.61, 0.89]), identified as the strongest preferences of parents accessing unscheduled healthcare for their children. Discussion: The results have implications for policy development and implementation initiatives that seek to improve unscheduled health services as understanding how parents use these services can maximise their effectiveness. Patient or Public Contribution: The development of the DCE included a qualitative research component to ensure that the content accurately reflected parents experiences when seeking healthcare. Before data collection, a pilot test was carried out with the target population to gather their views on the survey.