To get a better estimate of the expected LOD ratio between Average and single visits, and between SHAVE and Average, we generated charts based on a hypothetical dataset with multiple visits (from 2 to 10 visits).
The number of weekly influenza-attributed ED visits was calculated as the difference between model-predicted visits and the model-predicted visits under the hypothetical absence of influenza (baseline).
In addition to analyzing the cost of CHW visits relative to return rates as observed, we considered hypothetical alternative policies for CHW visits.
Time to help-seeking was hypothetical (how soon would you visit the doctor if…), and hypothetical intentions do not always translate into action (Sheeran, 2002).
Patients in the UK were invited to rate a series of symptoms to the extent that they were 'cancer' symptoms (knowledge) and interviewed about whether the symptoms would prompt them to visit a doctor (hypothetical help seeking behaviour).
Limitations include the reliance on hypothetical questions about barriers to visiting the GP, and the assumption that people will be aware of the key barriers in their own situation.
Interestingly, the type of health structure visited did not vary much according to severity, both in the retrospective and hypothetical questionnaire, with health centers as the most frequently visited structures, followed by health posts.
Similarly, expected LOD ratios increase as the number of visits increases, and saturates as the number of visits k becomes large, based on equation 4. When comparing SHAVE vs Average, we assumed a hypothetical dataset in which 50% of the individuals had a single visit and 50% of the individuals had k visits (from 2 to 10) (Supplementary Materials Figure S1).
For each appointment type, we sequentially imposed hypothetical policies where the maximum number of CHW visits was set at higher and higher levels.
The figure shows our proposals for a hypothetical participant who attends only four of the nine visits (solid line).
