Unlocking Patient Preferences for Community-based Health Facilities in Kapasia Upazila, Bangladesh: A Rating-based Conjoint Study

Background: Understanding patient preferences is crucial for improving the quality and utilization of health services in community-based health facilities (CBHF). By taking into account the patient’s perspective, needs, and values, the healthcare facility that serves the healthcare service users must be assessed. Therefore, when assessing and designing the healthcare facility, it might be useful to prioritize patients’ needs, preferences, and values in many facets of a health program. Objectives: This study aimed to identify patients’ preferences towards community-based health facilities and to measure their preferences for these health facilities. Materials and Method: The study participants were patients of the community clinic (CC) at Kapasia Upazila in Gazipur district. A rating-based Conjoint Analysis (CA) questionnaire was administered to the 434 patients. They were asked about the relative importance score (RIS) of six attributes along with 16 hypothetical scenarios that elicit preferences for the services of CBHF. The linear additive utility model was applied to evaluate the preference functions of each participant. Findings: The result of the conjoint analysis showed that the healthcare provider was the most influential attribute for CC, contributing 47.13 % to the respondents’ preference rating. Always availability of medicine at the clinic was the second most important attribute (RIS= 26.69%), followed by payment for health service (12.87%). Distance to the health center (5.45%), Waiting time till visit (5.39%) and community participation (2.47%) were least important. Moreover, the most substantial finding of the study is that patients choose that hypothetical scenario from where they get maximum utility. A single utility score indicates the level of desire for specific service features offered in a set of possible healthcare packages. Conclusion: By understanding patient preferences and experiences, this study seeks to inform policy and practice aimed at strengthening CBHC services in Bangladesh. Findings will help build patient-centered approaches that meet varied populations’ needs and priorities, advancing UHC.