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Objectives: Patient-centered care is seen as a critical factor in a high-performance healthcare system. We considered a randomized decision-situation in which the available information is given by three hypothetical health states. Methods: Within a discrete-choice experiment 21 characteristics of a healthcare delivery system are being used to construct 4 DCEs based on thematic mapping (patient-involvement; point of care; personnel; organization). Each DCE included six attributes with three specific levels. Respondents were randomly assigned and asked to make their decisions based on different information sets. Results: For N=3900 respondents the feature “out-of-pocket costs” was the important attribute across all 4 DCEs (DCE-1coefficient: 0,6550; DCE-2coefficient: 0,8624; DCE-3coefficient, 0,6991; DCE-4coefficient, 0,7926). The relevance of the “out-of-pocket cost” changed when respondents were asked to consider their responses in the context of diabetes or lung cancer diagnosis (statusquo: 0.6749; diabetes: 0.81145; lung-cancer: 0.50431). Furthermore, the feature “trust and respect” (status-quo: 0.70338; diabetes: 0.65555; lung-cancer: 0.6369) was also less valuable when participants assumed a worse health state. Conclusions: The study aimed to close the gap between simplistic representations of patient preferences in today’s healthcare systems and the complexity of actual patient decision-making processes by using the explanatory power of DCEs. Understanding how patients perceive and value different aspects of coordinated-care is vital to the optimal design and evaluation of programs.

Patient-centered health care delivery systems: does expected utility change depending on different information regarding the disease?