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Article

Preference of Older Adults for Flexibility in Service and Providers in Community-Based Social Care: A Discrete Choice Experiment

Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Academic Editors: Pedro Melo, José Ramón Riera and Tam Nguyen
Int. J. Environ. Res. Public Health 2022, 19(2), 686; https://doi.org/10.3390/ijerph19020686
Received: 23 November 2021 / Revised: 29 December 2021 / Accepted: 5 January 2022 / Published: 8 January 2022
Empowerment of control and choice of the service users in health and social care has been incorporated into service provision in various countries. This study aimed to elicit the preference of community-based long-term care (LTC) service users on levels of flexibility in service provision. A discrete choice experiment was performed among older community care service users to measure their preference for attributes of LTC services identified from a prior qualitative study. Each participant was asked to make choices in six choice tasks with two alternatives of hypothetical LTC services that were generated from the attributes. A generalized multinomial logistic model was applied to determine the relative importance and willingness to pay for the attributes. It found that the participants preferred multiple flexible providers, determining services by themselves, meeting case managers every month and social workers as sources of information on service provision. Significant preference heterogeneity was found for flexibility in providers and flexibility in services between those with and without activity of daily living impairment. The findings highlighted the preference of older adults for greater flexibility in LTC, while they rely heavily on social workers in decision making. The enhancement of flexibility in LTC should be supported by policies that allow the older service users to make decisions based on their own preferences or communication with social workers instead of determining the services and providers for them. Options should be offered to users to decide their preferred level of flexibility to better reflect their divided preferences. View Full-Text
Keywords: long-term care; home and community-based care; self-directed care; consumer-directed care; personal budgets; decision-making; conjoint analysis; willingness to pay long-term care; home and community-based care; self-directed care; consumer-directed care; personal budgets; decision-making; conjoint analysis; willingness to pay
MDPI and ACS Style

Wang, K.; Wong, E.L.-Y.; Wong, A.Y.-K.; Cheung, A.W.-L.; Yeoh, E.-K. Preference of Older Adults for Flexibility in Service and Providers in Community-Based Social Care: A Discrete Choice Experiment. Int. J. Environ. Res. Public Health 2022, 19, 686. https://doi.org/10.3390/ijerph19020686

AMA Style

Wang K, Wong EL-Y, Wong AY-K, Cheung AW-L, Yeoh E-K. Preference of Older Adults for Flexibility in Service and Providers in Community-Based Social Care: A Discrete Choice Experiment. International Journal of Environmental Research and Public Health. 2022; 19(2):686. https://doi.org/10.3390/ijerph19020686

Chicago/Turabian Style

Wang, Kailu, Eliza L.-Y. Wong, Amy Y.-K. Wong, Annie W.-L. Cheung, and Eng-Kiong Yeoh. 2022. "Preference of Older Adults for Flexibility in Service and Providers in Community-Based Social Care: A Discrete Choice Experiment" International Journal of Environmental Research and Public Health 19, no. 2: 686. https://doi.org/10.3390/ijerph19020686

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