JMIR Publications

ABSTRACT

Background:

China and the US play critical leading roles in the global effort to contain the COVID-19 virus, and as such, they directly or indirectly influence the attributes of the pandemic. Therefore, their population’s preferences for initial diagnosis in the case were compared to provide policy and clinical insights. We aim to quantify and compare China and the US population’s preferences for attributes of initial diagnosis in the case of presenting symptoms, especially fever during the COVID-19 pandemic.

Objective:

To quantify and compare the Chinese and US public’s preferences for medical treatment in the case of fever during the COVID-19 pandemic and to evaluate whether differences exist in people’s preferences.

Methods:

We conducted a cross-sectional study in China and the US by issuing an online discrete choice experiment questionnaire. Propensity score matching (PSM) was used to match the two groups of the participants from China and the US with the confounding variables. In addition, the respondents’ preference for different diagnosis options was evaluated by multinomial logit models and latent class models.

Results:

A total of 9,112 respondents (5,411 from China and 3,701 from the US) who completed our survey and quality-controlled were included in our analysis. After PSM, 1,240 respondents from China and 1,240 from the US were matched according to basic demographic information, gender, age, etc. Respondents from China attached the most importance to the medical institution type, while respondents from the US valued the cost of diagnosis as the most essential attribute. Respondents from China preferred the emergency department and fever clinic (a special clinic for the treatment of fever patients, which the outpatient department of regular hospitals establishes according to the instructions of the superior during the prevention and control of acute infectious diseases in China), while those from the US considered private clinic as the most preferred. Both populations preferred doctors most rather than nurses and paramedics as the medical staff. Additionally, shorter waiting time, immediate COVID-19 nucleic acid testing arrangement, higher reimbursement and lower cost were always preferred. The latent class analysis identified that, for respondents from China, some attached most importance on reimbursement rate rather than types of clinics. Similarly, some respondents from the US preferred reimbursement rate rather than cost.

Conclusions:

Respondents from China and the US have different preferences for attributes of initial diagnosis. Policymakers in China should focus on the types of clinics construction and improvement of reimbursement rate of the medical insurance. In contrast, those in the US should focus on reducing diagnosis costs and raising the reimbursement rate of medical insurance.