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Survey of Preferences in Patients Scheduled for Carpal Tunnel Release Using Conjoint Analysis

  • Kim, Wan Lim (Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jin Sam (Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jun Bum (Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Sun Hwa (Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Min, Dong-Uk (Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Ho Youn (Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2016.09.11
  • Accepted : 2016.12.14
  • Published : 2017.03.01

Abstract

Background: This study aimed to investigate the preferences of patients scheduled for carpal tunnel release using conjoint analysis and also introduce an example of how to apply a conjoint analysis to the medical field. The use of conjoint analysis in this study is new to the field of orthopedic surgery. Methods: A total of 97 patients scheduled for carpal tunnel release completed the survey. The following four attributes were predefined: board certification status, distance from the patient's residency, medical costs, and waiting time for surgery. Two plausible levels for each attribute were assigned. Based on these attributes and levels, 16 scenarios were generated ($2{\times}2{\times}2{\times}2$). We employed 8 scenarios using a fractional factorial design (orthogonal plan). Preferences for scenarios were then evaluated by ranking: patients were asked to list the 8 scenarios in their order of preference. Outcomes consisted of two results: the average importance of each attribute and the utility score. Results: The most important attribute was the physician's board certificate, followed by distance from the patient's residency to the hospital, waiting time, and costs. Utility estimate findings revealed that patients had a greater preference for a hand specialist than a general orthopedic surgeon. Conclusions: Patients considered the physician's expertise as the most important factor when choosing a hospital for carpal tunnel release. This suggests that patients are increasingly seeking safety without complications as interest in medical malpractice has increased.

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