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Health system choice

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  • Paul Scuffham
  • Jennifer Whitty
  • Matthew Taylor
  • Ruth Saxby

Abstract

Citizen preferences surrounding desirable health system characteristics should be considered when undertaking health system reform. The objective of this study was to pilot test a discrete-choice instrument designed to elicit preference weights surrounding health system attributes. A discrete-choice experiment was designed and administered to two convenience samples (n=50 each) recruited from the UK and Australia. The impact of eight health system attributes representing level of health, equity, responsiveness and healthcare financing on the choice between hypothetical health systems was analysed utilizing mixed logit analysis. All characteristics affected the likelihood a health system would be preferred, with the exception of the additional tax contribution levels required to finance the system. There were very few missing or inconsistent responses. The direction of preferences was consistent with expectations for both samples; that is, an improvement in attributes describing level of health, equity or responsiveness increased the likelihood that a health system would be preferred. A number of potential improvements to the preference instrument are suggested. The discrete-choice technique used in this study offers a feasible method for eliciting health system preferences, and its use in a larger-scale study to elicit and compare the preferences of representative population samples is supported. Copyright Adis Data Information BV 2010

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  • Paul Scuffham & Jennifer Whitty & Matthew Taylor & Ruth Saxby, 2010. "Health system choice," Applied Health Economics and Health Policy, Springer, vol. 8(2), pages 89-97, March.
    • Handle: RePEc:spr:aphecp:v:8:y:2010:i:2:p:89-97
    DOI: 10.2165/11531170-000000000-00000
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    References listed on IDEAS

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    2. Costa -Font, Joan & Forns, Joan Rovira & Sato, Azusa, 2015. "Participatory health system priority setting: Evidence from a budget experiment," Social Science & Medicine, Elsevier, vol. 146(C), pages 182-190.
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    4. Marta Trapero-Bertran & Beatriz Rodríguez-Martín & Julio López-Bastida, 2019. "What attributes should be included in a discrete choice experiment related to health technologies? A systematic literature review," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-15, July.
    5. Pan Zhang & Feng‐Mei Xing & Chang‐Zai Li & Feng‐Lan Wang & Xiao‐Li Zhang, 2018. "Effects of a nurse‐led transitional care programme on readmission, self‐efficacy to implement health‐promoting behaviours, functional status and life quality among Chinese patients with coronary arter," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(5-6), pages 969-979, March.
    6. Naoru Koizumi & Aileen Rothbard & Tony Smith & Jeremy Mayer, 2011. "Communities of color? Client-to-client racial concordance in the selection of mental health programs for Caucasians and African Americans," Health Care Management Science, Springer, vol. 14(4), pages 314-323, November.
    7. Adele Diederich & Joffre Swait & Norman Wirsik, 2012. "Citizen Participation in Patient Prioritization Policy Decisions: An Empirical and Experimental Study on Patients' Characteristics," PLOS ONE, Public Library of Science, vol. 7(5), pages 1-10, May.

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