Predicting the place of out-of-hours care--a market simulation based on discrete choice analysis.

BACKGROUND Increasing cost pressure and changing patients' needs in the healthcare sector have led to new delivery models for primary care. Researchers and practitioners need to establish innovative methods to obtain insights into patients' preferences and effectiveness of healthcare services. AIM This study reveals the crucial decision criteria of patients in choosing out-of-hours services and provides a projection of a future market share of the newly established central out-of-hours service, called General Practitioner Cooperative. DESIGN A computer-aided discrete choice experiment. METHOD Respondents were 350 patients in a European city who decided for a service when confronted with a medical emergency in an out-of-hours case; two scenarios called 'adult' and 'child', describing the persons requiring medical assistance, were used to increase generalizability. RESULTS The two most important attributes were 'explanation by the doctor' and 'waiting time' while the others - 'availability of technical equipment', 'ease of access', 'type of consultation' and 'payment method' - were of less importance. The market share projections predict that the new General Practitioner Cooperative will capture about one third of the market ('adult': 39.1%, 'child': 31.3%), ahead of the emergency department, the second most preferred service ('adult': 32.7%, 'child': 30.7%). CONCLUSIONS This study quantifies the adoption of a new medical service. As a result, it extends current research approaches on eliciting and matching patient's needs and assists policy makers in establishing adequate service capacities.