# Preferences for innovations in healthcare delivery models in the Swiss elderly population: a latent class, choice modelling study

## TL;DR

This study explores how Swiss elderly people feel about changes in healthcare delivery, finding three distinct groups with different preferences for coordinated care models.

## Contribution

The study identifies three distinct preference profiles for healthcare reforms among Swiss older adults using latent class analysis.

## Key findings

- Three classes of individuals were identified with different openness to healthcare reforms.
- Class 1 preferred integrated care with interprofessional teams but worried about premium increases.
- Class 3 was strongly reluctant to any changes in the healthcare system.

## Abstract

With the increasing number of people affected by multiple chronic conditions, it is essential for public-health professionals to promote strategies addressing patient needs for coordinated care. We aim to explore preference heterogeneity for better-coordinated care delivery models in Swiss older adults, and identify profiles of individuals more open to healthcare reforms.

A DCE (discrete choice experiment) survey was developed online and on paper for the Swiss adults aged 50+, following best practice. To elicit preferences, we estimated a latent class model allowing grouping individuals with similar preferences into distinct classes, and examined what background characteristics contributed to specific class membership.

The optimal model identified three classes with different openness to reforms. Class 1 (49%) members were concerned with premium increases and were in favour of integrated care structures with care managed by interprofessional teams. Individuals in class 2 (19%) were younger, open to reforms, and expressed the needs for radical changes within the Swiss healthcare system. Class 3 respondents (32%) were strongly reluctant to changes.

Our study goes beyond average preferences and identifies three distinct population profiles, a majority open to reforms on specific aspects of care delivery, a smallest group in favour radical changes, and a third strongly against changes. Therefore, tailored approaches around healthcare reforms are needed, e.g. explaining the role of interprofessional teams in coordinating care, electronic health records and insurance premium variation.