Fertility clinicians and infertile patients in China have different preferences in fertility care

Q. F. Cai, F. Wan, X. Y. Dong, X. H. Liao, J. Zheng, R. Wang, L. Wang, L. C. Ji, H. W. Zhang

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Abstract

STUDY QUESTIONDo the preferences for fertility care of infertile Chinese patients differ from those of fertility care providers?SUMMARY ANSWERInfertile Chinese patients attached the greatest importance to physicians' attitude but, in contrast, fertility care providers in China considered treatment effectiveness to be the most important factor in fertility care.WHAT IS KNOWN ALREADYIn Europe, physicians underestimate the importance of patient-centred infertility care.STUDY DESIGN, SIZE, DURATIONA conjoint survey was distributed among 417 female infertile Chinese patients and 83 fertility care providers from February 2013 to August 2013.PARTICIPANTS/MATERIALS, SETTING, METHODSIn this pilot study, 389 patients and 83 fertility care providers completed the survey at three reproductive medicine centres. Rating-based conjoint analysis was performed to elicit patients' and their caregivers' preferences regarding fertility care. Cluster analysis was used to explore the heterogeneity among patients' preferences.MAIN RESULTS AND THE ROLE OF CHANCEWhen searching for fertility care, patients valued the physicians' attitude the most, followed by success rates, distance from home to the fertility centre, physician continuity throughout the treatment period and type of fertility centre. Fertility care providers considered success rates (effectiveness) to be the most important factor when recommending a fertility centre. Fertility patients and care providers had significantly different views on the value of treatment effectiveness, physician attitude and physician continuity (P-values <0.05). Cluster analysis revealed that patients' preferences were heterogeneous. LIMITATIONS, REASONS FOR CAUTIONThe sample size is relatively small, and there is insufficient power for heterogeneity analysis. Two levels for each of five design factors (25) may not fully capture the characteristics of realistic fertility centres. Rating-based conjoint analysis could be inferior to choice-based conjoint analysis in terms of predictive accuracy.WIDER IMPLICATIONS OF THE FINDINGSFertility care providers in China significantly underestimate the importance of patient-centredness to infertile patients. To deliver optimal fertility care to infertile Chinese patients, fertility care providers need to understand the importance of patient-centred care, such as a friendly attitude, sympathy for patients' suffering, respect for patients' right to informed consent and a transparent treatment process.STUDY FUNDING/COMPETING INTEREST(S)This study was not funded, and there are no conflicts of interest.TRIAL REGISTRATION NUMBERNone.

Original languageEnglish
Pages (from-to)712-719
Number of pages8
JournalHuman Reproduction
Volume29
Issue number4
DOIs
StatePublished - Jan 1 2014

Keywords

  • Conjoint survey
  • Fertility care
  • Patient preferences
  • Patient-centredness
  • Treatment effectiveness

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    Cai, Q. F., Wan, F., Dong, X. Y., Liao, X. H., Zheng, J., Wang, R., Wang, L., Ji, L. C., & Zhang, H. W. (2014). Fertility clinicians and infertile patients in China have different preferences in fertility care. Human Reproduction, 29(4), 712-719. https://doi.org/10.1093/humrep/deu023