The value of different aspects of person-centred care: a series of discrete choice experiments in people with long-term conditions

2017 
Objective To measure the value the patients place on different aspects of person-centred care. Design We systematically identified four attributes of person-centred care. We then measured their value to 923 people with either chronic pain or chronic lung disease over three discrete choice experiments (DCEs) about services to support self-management. We calculated the value of each attribute for all respondents and identified groups of people with similar preferences using latent class modelling. Setting DCEs conducted online via a commercial survey company. Participants Adults with either chronic pain (two DCEs, n=517 and 206, respectively) or breathlessness due to chronic respiratory disease (n=200). Results Participants were more likely to choose services with higher level person-centred attributes. They most valued services that took account of a person’s current situation likelihood of selection increased by 16.9% (95% CI=15.4 to 18.3) and worked with the person on what they wanted to get from life (15.8%; 14.5 to 17.1). More personally relevant information was valued less than these (12.3%; 11.0 to 13.6). A friendly and personal communicative style was valued least (3.8%; 2.7 to 4.8). Latent class models indicated that a substantial minority of participants valued personally relevant information over the other attributes. Conclusion This is the first study to measure the value patients place on different aspects of person-centred care. Professional training needs to emphasise the substance of clinical communication—working responsively with individuals on what matters to them—as well as the style of its delivery.
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