Preferences and willingness to pay for palliative care among parents of children with cancer: a Discrete Choice Experiment.

PURPOSE: To quantify the preference of parents of children with cancer for palliative care (PC) in China to provide references for the development of service programs.

METHODS

A discrete choice experiment (DCE) was used to explore preferences for PC among parents of children with cancer. The conditional logit and mixed logit models were employed to estimate the parents' preferences. Furthermore, we calculated the willingness to pay (WTP) and simulated how variations in attribute levels influenced the probability of parental service acceptance. Meanwhile, preference heterogeneity among parents was also investigated through subgroup analysis.

RESULTS

A total of 583 fully completed responses were incorporated in the final data analysis. The out-of-pocket payments was the most influential attribute, followed by the quality of life (QoL) and the content of services. Notably, we found that there were differences in the preferences of fathers and mothers regarding the content and place of services. Mothers displayed higher preferences for PC services which provide improved QoL, lower out-of-pocket costs, increasing service frequency, and psychological support at home, with the maximum WTP of 202.331 CNY each time. While fathers showed higher preferences for PC services with better QoL, fewer out-of-pocket payments, higher frequency and respite care, with the maximum WTP of 169.944 CNY.

CONCLUSION

The findings suggest that in addition to minimizing out-of-pocket services expenses, improving QoL during PC and providing personalized service content also deserve more attention. Moreover, we found that home care and psychological support were preferred by mothers, whereas fathers leaned towards respite care. This preferences heterogeneity among parents highlights the importance of providing tailored services.