Patient Preferences for Radiology Appointments and Factors Influencing Attendance Adherence: A Discrete Choice Experiment in Singapore Based on Behavioral Economics

OBJECTIVES: Missed radiology appointments disrupt timely diagnosis and result in resource inefficiencies. This study aims to investigate patient preferences for radiology appointments and explore adherence factors through the lens of behavioral economics.

METHODS: A discrete choice experiment survey was developed based on 6 attributes: (1) "Waiting time for the radiology appointment," (2) "Choice of appointment time," (3) "Reminder system," (4) "Out-of-pocket (OOP) costs," (5) "Upfront deposit fee," and (6) "Time taken to receive results." The online survey was administered in English, and responses were collected face to face. Respondents were outpatients aged 21 years and older with radiology appointments. Data analysis was performed using the Stata version 16.1, with conditional logit and mixed logit models used to analyze the discrete choice experiment data.

RESULTS: OOP costs were the primary driver of patient preferences for radiology appointments, followed by waiting time, timeliness of results, and choice of appointment reminders, whereas deposit requirements had mixed effects and appointment time had little impact. Both conditional and mixed logit models produced consistent attribute rankings, with OOP costs accounting for more than 80% of total utility. The mixed logit model revealed significant preference heterogeneity, particularly for costs and reminders. Willingness-to-pay estimates showed that patients valued flexible reminder systems the most, being willing to pay more than SGD 200 compared with reminder-only services, while requiring compensation for deposits or longer waiting times.

CONCLUSIONS: Optimising OOP costs and providing flexible reminders with cancellation or rescheduling options may improve patient adherence, engagement, and satisfaction in radiology.