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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)

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

Volume (Year): 18 (2009)
Issue (Month): 8 ()
Pages: 903-920
Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
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. 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. [Downloadable!] (restricted)
  2. Harry Telser & Peter Zweifel, 2007. "Validity of discrete-choice experiments evidence for health risk reduction," Applied Economics, Taylor and Francis Journals, vol. 39(1), pages 69-78, January. [Downloadable!] (restricted)
  3. San Miguel, Fernando & Ryan, Mandy & McIntosh, Emma, 2000. "Applying Conjoint Analysis in Economic Evaluations: An Application to Menorrhagia," Applied Economics, Taylor and Francis Journals, vol. 32(7), pages 823-33, June. [Downloadable!] (restricted)
  4. 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. [Downloadable!] (restricted)
  5. 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. [Downloadable!] (restricted)
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