BMC health services research · 2026
Coronary artery bypass grafting patients' preferences and willingness to pay for remote cardiac rehabilitation: discrete choice experiment study.
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Song Dongyu, Lyu Shanshan, Zhang Haizhou, Wang Huihui, Li Guixia, Jiang Shuangyan, Liu Xianfeng, Zheng Jing
Аннотация
BACKGROUND: Cardiac rehabilitation (CR) uptake among coronary artery bypass grafting (CABG) patients in China is extremely low. Remote cardiac rehabilitation (RCR) offers a promising alternative, but its design must be informed by patient's preferences to ensure adoption. This study aimed to quantify CABG patients' preferences and willingness-to-pay (WTP) for key RCR attributes to inform patient-centered service design.
METHODS: A discrete choice experiment was administered to CABG patients, assessing preferences across six RCR attributes: service content, service provider, degree of personalization, monitoring method, content model, and cost. Data were analyzed using a mixed logit model to estimate preferences, WTP, and relative importance (RI). Subgroup analyses by gender and age were performed.
RESULTS: A total of 343 CABG patients participated in the study, of whom 69.39% were male, with a mean age of 61.69 (SD = 10.33) years. Within the present DCE model, service provider emerged as the most critical attribute (RI = 45.54). Patients strongly preferred services led by multidisciplinary teams (β = 1.70***, WTP = CNY 92.65/month), followed by doctor-led services (β = 1.09***, WTP = CNY 59.21/month). Continuous automatic monitoring via wearable devices (β = 0.90***, WTP = CNY 49.32/month) was also highly valued. Personalized plans based on discharge assessment were preferred over standardized fixed protocols (β = 0.36*, WTP = CNY 19.50/month). Cost had a significant negative impact on choice (RI = 8.21; β=-0.02**). Video content was preferred over text (β = 0.52***, WTP = CNY 28.33/month), while voice format showed no significant effect. In this subgroup analysis, male patients showed significant preferences for a wider range of attributes, whereas female patients showed significant preferences primarily for service provider. Younger patients (≤ 60 years) also favored personalized based on discharge assessment, while older patients (> 60 years) preferred AI assistant + regular review by team members and comprehensive programs.
CONCLUSIONS: CABG patients prioritize professional, integrated support and convenient technology in RCR. Program development should emphasize multidisciplinary teams, wearable devices, and video content. These patient-informed strategies are essential to enhance engagement and address the low CR uptake.
METHODS: A discrete choice experiment was administered to CABG patients, assessing preferences across six RCR attributes: service content, service provider, degree of personalization, monitoring method, content model, and cost. Data were analyzed using a mixed logit model to estimate preferences, WTP, and relative importance (RI). Subgroup analyses by gender and age were performed.
RESULTS: A total of 343 CABG patients participated in the study, of whom 69.39% were male, with a mean age of 61.69 (SD = 10.33) years. Within the present DCE model, service provider emerged as the most critical attribute (RI = 45.54). Patients strongly preferred services led by multidisciplinary teams (β = 1.70***, WTP = CNY 92.65/month), followed by doctor-led services (β = 1.09***, WTP = CNY 59.21/month). Continuous automatic monitoring via wearable devices (β = 0.90***, WTP = CNY 49.32/month) was also highly valued. Personalized plans based on discharge assessment were preferred over standardized fixed protocols (β = 0.36*, WTP = CNY 19.50/month). Cost had a significant negative impact on choice (RI = 8.21; β=-0.02**). Video content was preferred over text (β = 0.52***, WTP = CNY 28.33/month), while voice format showed no significant effect. In this subgroup analysis, male patients showed significant preferences for a wider range of attributes, whereas female patients showed significant preferences primarily for service provider. Younger patients (≤ 60 years) also favored personalized based on discharge assessment, while older patients (> 60 years) preferred AI assistant + regular review by team members and comprehensive programs.
CONCLUSIONS: CABG patients prioritize professional, integrated support and convenient technology in RCR. Program development should emphasize multidisciplinary teams, wearable devices, and video content. These patient-informed strategies are essential to enhance engagement and address the low CR uptake.