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Examining the attitudes and preferences of health care decision-makers in relation to access, equity and cost-effectiveness: A discrete choice experiment

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  • Ratcliffe, Julie
  • Bekker, Hilary L.
  • Dolan, Paul
  • Edlin, Richard

Abstract

Objectives To describe the views of health care decision-makers and providers operating in the UK National Health Service (NHS) concerning the concepts of cost-effectiveness, equity and access through a series of attitudinal questions; to evaluate the preferences of health care providers in relation to each of these concepts using a discrete choice experiment (DCE); to assess the impact of prior completion of an attitude questionnaire on preferences elicited through a DCE.Method Three versions of a DCE questionnaire were developed with and without a series of attitudinal questions and randomly distributed to 1456 health care decision-makers and providers. The questionnaire sought to elicit their preferences between the competing objectives of cost-effectiveness, equity and access within the context of different hypothetical, specialist treatment programmes for cardiovascular disease.Results The response rate was 26%. Female respondents exhibited a stronger preference than males for reducing health inequalities by targeting the worst off (Wald test, P

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  • Ratcliffe, Julie & Bekker, Hilary L. & Dolan, Paul & Edlin, Richard, 2009. "Examining the attitudes and preferences of health care decision-makers in relation to access, equity and cost-effectiveness: A discrete choice experiment," Health Policy, Elsevier, vol. 90(1), pages 45-57, April.
    • Handle: RePEc:eee:hepoli:v:90:y:2009:i:1:p:45-57
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    5. Philips, Hilde & Mahr, Dominik & Remmen, Roy & Weverbergh, Marcel & De Graeve, Diana & Van Royen, Paul, 2012. "Predicting the place of out-of-hours care—A market simulation based on discrete choice analysis," Health Policy, Elsevier, vol. 106(3), pages 284-290.
    6. Emily Lancsar & Peter Burge, 2014. "Choice modelling research in health economics," Chapters, in: Stephane Hess & Andrew Daly (ed.), Handbook of Choice Modelling, chapter 28, pages 675-687, Edward Elgar Publishing.
    7. Jeroen Luyten & Sandy Tubeuf & Roselinde Kessels, 2022. "Rationing of a scarce life‐saving resource: Public preferences for prioritizing COVID‐19 vaccination," Health Economics, John Wiley & Sons, Ltd., vol. 31(2), pages 342-362, February.
    8. Lane, Haylee & Sarkies, Mitchell & Martin, Jennifer & Haines, Terry, 2017. "Equity in healthcare resource allocation decision making: A systematic review," Social Science & Medicine, Elsevier, vol. 175(C), pages 11-27.
    9. Mavromaras, Kostas & Isherwood, Linda & Mahuteau, Stephane & Ratcliffe, Julie & Xiao, Lily & Harrington, Ann & Wei, Zhang, 2022. "Job Preferences of Aged Care Workers in Australia: Results from a Discrete Choice Experiment," IZA Discussion Papers 15623, Institute of Labor Economics (IZA).
    10. Thompson, Ceri R. & McKee, Martin, 2011. "An analysis of hospital capital planning and financing in three European countries: Using the principal-agent approach to identify the potential for economic problems," Health Policy, Elsevier, vol. 99(2), pages 158-166, February.

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