| ObjectiveAnalyzing breast cancer patients’ preference for follow-up after surgery services and the trade-off process,predicting the effectiveness of breast cancer patients on different follow-up programs,and providing references for optimizing follow-up after surgery services for breast cancer patients,then improving the quality of follow-up services and improve patients’ follow-up compliance and their quality of life.MethodsFirst,this study reviewed domestic and foreign research literature on cancer patients’ preferences and needs for follow-up services,analyzed and sorted out the relevant factors that influence cancer patients’ use of followup services.Then,based on semi-structured interviews and expert consultation,the attributes and levels of discrete choice experiments were determined.Using SAS to perform D-efficiency analysis to generate selection sets of attributes and levels,formulate discrete choice experimental questionnaires and conduct pre-surveys before conducting formal surveys.A total of 5 hospitals in Foshan,Guangdong Province were selected for the convenience sampling study to determine the follow-up after surgery service preferences of breast cancer patients who met the inclusion criteria from August 2021 to December 2021.The descriptive data was analyzed using SPSS 20.0 software.With the help of Stata 16.0software,a mixed Logit model was fitted to quantify the choice of followup after surgery service preference and willingness to pay of breast cancer patients.Results1.A total of 268 questionnaires were distributed in this study.Following the elimination of invalid questionnaires,232 valid questionnaires were eventually included,and the recovery rate of valid questionnaires was 86.6%.2.Five of the seven attributes included in this study have a significant impact on breast cancer patients’ preferences for follow-up after surgery services,including follow-up personnel,follow-up methods,consultation content,out-of-pocket costs,and follow-up frequency.The attribute with the greatest impact on patients was “follow-up staff”,while the lowest preference for the level “general practitioner”(β =-2.20).3.According to the results of the willingness to pay survey,general practitioners as follow-up personnel would reduce patients’ willingness to pay by 2678.88 yuan.There is a significant preference among breast cancer patients for obtaining psychosocial health counseling content during follow-up(β = 0.26),and breast cancer patients are willing to spend 312.91 yuan on this relevant counseling content.4.The scheme with the most utility value,out of the 5 attributes with significant significance,is: breast specialists(or breast specialist nurses)as follow-up staff,conduct face-to-face follow-up,follow-up every 3 months,provide psychosocial health counseling,and 100 yuan for self-payment.5.By simulating the follow-up plan,after changing a single level,it is the general practitioner who has the greatest impact on choosing the follow-up plan: in comparison with the baseline plan,the proportion of patients accepting the general practitioner’s service plan will be reduced by 80.12%.Several levels were changed simultaneously,and the followup plans of “breast specialist nurse + social psychological guidance +follow-up every 3 months” and “breast specialist + social psychological guidance + follow-up every 3 months” increased compared with the baseline plan.The selection probabilities are 25.39% and 29.49%,respectively.6.Subgroup analysis indicated that breast cancer patients with varying ages,education levels,employment status and family monthly income levels,and years of diagnosis had heterogeneous preferences for follow-up options.Patients aged <45 years old,with higher education level,higher incomes,and more than two years of diagnosis are less likely to seek follow-up care from general practitioners,and patients aged <45 years old and higher income prefer the follow-up care with lower out-of-pocket costs,whereas patients with age ≥ 45 years,lower education level,and higher income had a lower preference for We Chat/telephone follow-ups.Conclusions1.Breast cancer patients prefer to have breast specialists(or breast specialist nurses)as follow-up personnel,with low out-of-pocket costs and frequent follow-up,and hope to receive psychosocial counseling following treatment after surgery.2.It is imperative to pay attention to the role of specialist nurses in the follow-up management of breast cancer patients after surgery.Optimized the role of specialist nurses in evaluating and guiding the psychosocial aspects of breast cancer patients,reduce the uncertainty of the disease,and improve patient satisfaction with follow-up after surgery services.3.Breast cancer patients with different sociodemographic characteristics have different preferences for follow-up after surgery services.The provision of individualized and diverse forms of follow-up services is therefore necessary to improve patients’ follow-up compliance after surgery. |
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