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Background <p>Cardiac rehabilitation (CR) uptake among coronary artery bypass grafting (CABG) patients in China is extremely low. Remote cardiac rehabilitation (RCR) offers a promising alternative, but its design must be informed by patient’s preferences to ensure adoption. This study aimed to quantify CABG patients’ preferences and willingness-to-pay (WTP) for key RCR attributes to inform patient-centered service design.</p> Methods <p>A discrete choice experiment was administered to CABG patients, assessing preferences across six RCR attributes: service content, service provider, degree of personalization, monitoring method, content model, and cost. Data were analyzed using a mixed logit model to estimate preferences, WTP, and relative importance (RI). Subgroup analyses by gender and age were performed.</p> Results <p>A total of 343 CABG patients participated in the study, of whom 69.39% were male, with a mean age of 61.69 (SD = 10.33) years. Within the present DCE model, service provider emerged as the most critical attribute (RI = 45.54). Patients strongly preferred services led by multidisciplinary teams (<i>β</i> = 1.70<sup>***</sup>, WTP = CNY 92.65/month), followed by doctor-led services (<i>β</i> = 1.09<sup>***</sup>, WTP = CNY 59.21/month). Continuous automatic monitoring via wearable devices (<i>β</i> = 0.90<sup>***</sup>, WTP = CNY 49.32/month) was also highly valued. Personalized plans based on discharge assessment were preferred over standardized fixed protocols (<i>β</i> = 0.36<sup>*</sup>, WTP = CNY 19.50/month). Cost had a significant negative impact on choice (RI = 8.21; <i>β</i>=-0.02<sup>**</sup>). Video content was preferred over text (<i>β</i> = 0.52<sup>***</sup>, WTP = CNY 28.33/month), while voice format showed no significant effect. In this subgroup analysis, male patients showed significant preferences for a wider range of attributes, whereas female patients showed significant preferences primarily for service provider. Younger patients (≤ 60 years) also favored personalized based on discharge assessment, while older patients (&gt; 60 years) preferred AI assistant + regular review by team members and comprehensive programs.</p> Conclusions <p>CABG patients prioritize professional, integrated support and convenient technology in RCR. Program development should emphasize multidisciplinary teams, wearable devices, and video content. These patient-informed strategies are essential to enhance engagement and address the low CR uptake.</p>

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Coronary artery bypass grafting patients’ preferences and willingness to pay for remote cardiac rehabilitation: discrete choice experiment study

  • 期刊论文

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  • 发表日期：

    2026年6月2日

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  • Dongyu Song,
  • Shanshan Lyu,
  • Haizhou Zhang,
  • Huihui Wang,
  • Guixia Li,
  • Shuangyan Jiang,
  • Xianfeng Liu,
  • Jing Zheng

摘要

Background

Cardiac rehabilitation (CR) uptake among coronary artery bypass grafting (CABG) patients in China is extremely low. Remote cardiac rehabilitation (RCR) offers a promising alternative, but its design must be informed by patient’s preferences to ensure adoption. This study aimed to quantify CABG patients’ preferences and willingness-to-pay (WTP) for key RCR attributes to inform patient-centered service design.

Methods

A discrete choice experiment was administered to CABG patients, assessing preferences across six RCR attributes: service content, service provider, degree of personalization, monitoring method, content model, and cost. Data were analyzed using a mixed logit model to estimate preferences, WTP, and relative importance (RI). Subgroup analyses by gender and age were performed.

Results

A total of 343 CABG patients participated in the study, of whom 69.39% were male, with a mean age of 61.69 (SD = 10.33) years. Within the present DCE model, service provider emerged as the most critical attribute (RI = 45.54). Patients strongly preferred services led by multidisciplinary teams (β = 1.70***, WTP = CNY 92.65/month), followed by doctor-led services (β = 1.09***, WTP = CNY 59.21/month). Continuous automatic monitoring via wearable devices (β = 0.90***, WTP = CNY 49.32/month) was also highly valued. Personalized plans based on discharge assessment were preferred over standardized fixed protocols (β = 0.36*, WTP = CNY 19.50/month). Cost had a significant negative impact on choice (RI = 8.21; β=-0.02**). Video content was preferred over text (β = 0.52***, WTP = CNY 28.33/month), while voice format showed no significant effect. In this subgroup analysis, male patients showed significant preferences for a wider range of attributes, whereas female patients showed significant preferences primarily for service provider. Younger patients (≤ 60 years) also favored personalized based on discharge assessment, while older patients (> 60 years) preferred AI assistant + regular review by team members and comprehensive programs.

Conclusions

CABG patients prioritize professional, integrated support and convenient technology in RCR. Program development should emphasize multidisciplinary teams, wearable devices, and video content. These patient-informed strategies are essential to enhance engagement and address the low CR uptake.