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Discrete choice experiments for complex health-care decisions: does hierarchical information integration offer a solution?

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Author Info

  • Debby van Helvoort-Postulart

    (Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, The Netherlands)

  • Benedict G. C. Dellaert

    (Department of Business Economics, Section Marketing, Erasmus University Rotterdam, Rotterdam, The Netherlands)

  • Trudy van der Weijden

    (Department of General Practice, School of Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands)

  • Maarten F. von Meyenfeldt

    (Department of General Surgery, University Hospital Maastricht, Maastricht, The Netherlands)

  • Carmen D. Dirksen

    (Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, The Netherlands)

Abstract

This paper describes an application of hierarchical information integration (HII) discrete choice experiments. We assessed theoretical and construct validity, as well as internal consistency, to investigate whether HII can be used to investigate complex multi-faceted health-care decisions (objective 1). In addition, we incorporated recent advances in mixed logit modelling (objective 2). Finally, we determined the response rate and predictive ability to study the feasibility of HII to support health-care management (objective 3). The clinical subject was the implementation of the guideline for breast cancer surgery in day care, which is a complex process that involves changes at the organizational and management levels, as well as the level of health-care professionals and that of patients. We found good theoretical and construct validity and satisfactory internal consistency. The proposed mixed logit model, which included repeated measures corrections and subexperiment error scale variations, also performed well. We found a poor response, but the model had satisfactory predictive ability. Therefore, we conclude that HII can be used successfully to study complex multi-faceted health-care decisions (objectives 1 and 2), but that the feasibility of HII to support health-care management, in particular in challenging implementation projects, seems less favourable (objective 3). Copyright © 2008 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1411
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 18 (2009)
Issue (Month): 8 ()
Pages: 903-920

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Handle: RePEc:wly:hlthec:v:18:y:2009:i:8:p:903-920

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. J J Louviere & H J P Timmermans, 1990. "Using hierarchical information integration to model consumer responses to possible planning actions: recreation destination choice illustration," Environment and Planning A, Pion Ltd, London, vol. 22(3), pages 291-308, March.
  2. Ryan, Mandy, 1999. "Using conjoint analysis to take account of patient preferences and go beyond health outcomes: an application to in vitro fertilisation," Social Science & Medicine, Elsevier, vol. 48(4), pages 535-546, February.
  3. Wiktor Adamowicz & David Bunch & Trudy Cameron & Benedict Dellaert & Michael Hanneman & Michael Keane & Jordan Louviere & Robert Meyer & Thomas Steenburgh & Joffre Swait, 2008. "Behavioral frontiers in choice modeling," Marketing Letters, Springer, vol. 19(3), pages 215-228, December.
  4. Bettman, James R. & Johnson, Eric J. & Payne, John W., 1990. "A componential analysis of cognitive effort in choice," Organizational Behavior and Human Decision Processes, Elsevier, vol. 45(1), pages 111-139, February.
  5. Scott, Anthony & Vick, Sandra, 1999. "Patients, Doctors and Contracts: An Application of Principal-Agent Theory to the Doctor-Patient Relationship," Scottish Journal of Political Economy, Scottish Economic Society, vol. 46(2), pages 111-34, May.
  6. San Miguel, Fernando & Ryan, Mandy & Scott, Anthony, 2002. "Are preferences stable? The case of health care," Journal of Economic Behavior & Organization, Elsevier, vol. 48(1), pages 1-14, May.
  7. Fernando San Miguel & Mandy Ryan & Emma McIntosh, 2000. "Applying conjoint analysis in economic evaluations: an application to menorrhagia," Applied Economics, Taylor & Francis Journals, vol. 32(7), pages 823-833.
  8. Harry Telser & Peter Zweifel, 2007. "Validity of discrete-choice experiments evidence for health risk reduction," Applied Economics, Taylor & Francis Journals, vol. 39(1), pages 69-78.
  9. Farrar, Shelley & Ryan, Mandy & Ross, Donald & Ludbrook, Anne, 2000. "Using discrete choice modelling in priority setting: an application to clinical service developments," Social Science & Medicine, Elsevier, vol. 50(1), pages 63-75, January.
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