Would you zoom with your doctor?:A discrete choice experiment to identify patient preferences for video and in-clinic consultations in German primary care

Introduction: The popularity of video consultations in healthcare has accelerated during the COVID-19 pandemic. Despite increased availability and obvious benefits, many patients remain hesitant to use video consultations. This study investigates the relative importance of the consultation mode compared to other attributes in patients’ appointment choices in Germany. Methods: A discrete choice experiment was conducted to examine the influence of appointment attributes on preferences for video over in-clinic consultations. A total of 350 participants were included in the analysis. Results: The level of continuity of care (46%) and the waiting time until the next available appointment (22%) were shown to have higher relative importance than consultation mode (18%) and other attributes. Participants with fewer data privacy concerns, higher technology proficiency, and more fear of COVID-19 tended to prefer video over in-clinic consultations. The predicted choice probability of a video over a typical in-clinic consultation and opting out increased from &lt;1% to 40% when the video consultation was improved from the worst-case to the best-case scenario. Conclusion: This study provides insight into the effect of the consultation mode on appointment choice at a time when telemedicine gains momentum. The results suggest that participants preferred in-clinic over video consultations. Policymakers and service providers should focus on increasing the level of continuity of care and decreasing the time until the next available appointment to prompt the adoption of video consultations. Although participants preferred to talk to their physician in person over consulting via video per se, the demand for video consultations can be increased significantly by improving the other appointment attributes of video consultations such as the level of continuity of care.</p

Phytoplankton abundance and size-fractionated structure in three contrasting periods in the Pear River Estuary

Phytoplankton abundance, composition and size-fractionated chlorophyll a (micro-, nano- and pico-chl. a) in the Pearl River Estuary (PRE), South China were assessed in three surveys (Aug. 2010, Jan. 2011 and Aug. 2011) to identify key environmental indicators that shape their distribution patterns. Non-metric multidimensional scaling (MDS) showed that the PRE formed three regional clusters that were characterized by a transition from dominant freshwater species to estuarine diatoms in normal summer flow conditions (Aug. 2010). With a reduced river flow in winter (Jan. 2011), the inner estuary was categorized as one group marked by the predominance of the nanoflagellate, Plagioselmis prolonga. This small-sized cryptophyte was first recorded in the PRE and was likely to outcompete other phytoplankton species in turbid or well-mixed waters. During the extreme drought of summer of 2011 (Aug. 2011), the estuarine plume was limited and regional division by MDS was similar to winter patterns, as some marine species were observed in the upper estuary. We considered that the higher phytoplankton density in the summer of 2011 was presumably a combined effect of longer residence time and higher phosphate concentration. With respect to the size-fractionated phytoplankton composition, our results showed that almost half of the chl. a in the estuary was contained in microplankton particles, while the proportion of pico-chl. a increased from the upstream of the PRE towards the estuary boundary (Wanshan Islands). Furthermore, phytoplankton abundance, three size classes of chl. a and environmental factors were explored by principal component regression (PCR) analysis. In three surveys, pico-chl. a was negatively correlated with the first principal component (PCL, positively loaded with salinity and inversely with inorganic nutrients), which indicated a negative influence of the riverine and coastal waters on picophytoplankton and the specific oligotrophic niche of picophytoplankton. Similarly, PC1 was also considered as the key environmental variable basis controlling micro-chl. a in summer of 2010, while in the summer of 2011, zooplankton and copepods were positively associated with phytoplankton abundance, suggesting a resource effect of phytoplankton on zooplankton development

Results of the 2016 ENtity Summarization Evaluation Campaign (ENSEC 2016)

Entities and their descriptions are becoming an important part of the datasets and knowledge graphs available on the Web. These descriptions can be used in concise representation (i.e., summaries) to help users understand the Web content (e.g., summaries generated from Google Knowledge Graph in Google Search). In the recent past, several systems emerged to tackle the problem of automatic summary generation for entity descriptions. Even though these proposed systems continuously push the boundaries, the problem is not yet resolved completely. Therefore, there is a need to support and encourage researchers in the community to participate in solving this important problem. ENSEC, the entity summarization evaluation campaign, is the first step taken towards realizing that goal, and we present the results of the systems participating in the campaign

The impact of hospital attributes on patient choice for first visit

The underutilization of primary care in urban China threatens the efficiency and effectiveness of the Chinese health system. To guide patient flow to primary care, the Chinese government has rolled out a sequence of health care reforms which improve the affordability, the infrastructure and workforce of the primary care system. However, these measures have not yielded the desired effect on the utilization of primary care, which is lowest in urban areas. It is unclear how the factors identified to influence facility choice in urban China are actually impacting choice behaviour. We conducted a discrete choice experiment to elicit the quantitative impact of facility attributes when choosing a health care facility for first visit and analysed how the stated choice varies with these attributes. We found that the respondents placed different weights on the identified attributes, depending on whether they perceived their condition to be minor or severe. For conditions perceived as minor, the respondents valued visit time, equipment and medical skill most. For conditions perceived as severe, they placed most importance on equipment, travel time and facility size. We found that for conditions perceived as minor, only 14% preferred visiting a facility over opting out, a percentage which would more than double to 37% if community health centres were maximally improved. For conditions perceived as severe, improvements in community health centres may almost double first visits to primary care, mostly from patients who would otherwise choose higher-level facilities. Our findings suggest that for both severity conditions, improvements to medical equipment and medical skill at community health centres in urban China can effectively direct patient flow to primary care and promote the efficiency and effectiveness of the urban health system