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March 25, 2026The European Journal of Health Economics2 citationsOpen Access

Unraveling acceptance of healthcare innovations in neurorehabilitation: results from a discrete choice experiment

AFAnn-Kathrin FischerASAndrew SadlerAMAxel Mühlbacher

Key Points

  • The research aims to quantify how various factors influence patient acceptance of digital neurorehabilitation technologies.
  • Conducted a discrete choice experiment among 1,259 individuals including stroke survivors.
  • Evaluated preferences for seven attributes of digital neurorehabilitation technologies.
  • Utilized a fractional factorial design and analyzed data using a mixed logit model.
  • Calculated willingness to pay and predicted uptake probabilities based on individual preferences.
  • Therapy success was the most influential factor on decision-making (β₁₀₀% = 1.47; p < .001).
  • Monthly copayment also significantly impacted acceptance (β₀€ = 0.86; p < .001).
  • Direct contact with professionals increased acceptance (β_direct = 0.54; p < .001).
  • Choice of therapy location and multimedia-based explanations were preferred, affecting acceptance positively.

Abstract

This study aimed to quantify patient preferences and assess how therapy success, copayment, and specific technical aspects influence acceptance of digital neurorehabilitation technologies. A Discrete Choice Experiment (DCE) was conducted among 1, 259 individuals, including stroke survivors and members of the general population, to evaluate preferences for seven attributes of digital neurorehabilitation technologies: therapy success (within 6 months), monthly copayment, and five technical aspects (e. g. , contact with professionals, therapy location, information provision, explanation format, and data processing). A fractional factorial design was applied, and data were analyzed using a Mixed Logit Model. Willingness to Pay (WTP) and predicted uptake probabilities (UP) were calculated based on individual preferences. Therapy success had the greatest influence on decision-making (β₁₀₀% = 1. 47; p <. 001), followed by monthly copayment (β₀€ = 0. 86; p <. 001). Relevant technical aspects included direct contact with professionals (βdirect = 0. 54; p <. 001) and choice of therapy location (βₚlace = 0. 33; p <. 001). Multimedia-based explanations were preferred over text (βᵥideo = 0. 26; βₘove = 0. 13; both p <. 001). Despite equal therapy success, UP varied substantially across modeled interventions (44%, 65%, and 84%) due to differences in technical aspects alone, as calculated from estimated WTP values. Acceptance of digital neurorehabilitation technologies can be systematically assessed using stated preference methods. The findings demonstrate that specific technical aspects can decisively influence acceptance, even when therapy success remains unchanged. This underscores the importance of incorporating patient-valued features into digital health design and provides actionable insights for policy makers and payers aiming to support effective and accepted digital care models.

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Cite This Study

Fischer et al. (2026) studied this question.

synapsesocial.com/papers/69c37aa8b34aaaeb1a67c93bhttps://doi.org/10.1007/s10198-026-01914-7
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