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Preferences of Bulgarian consumers for quality, access and price attributes of healthcare services—result of a discrete choice experiment

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  • Thijs Schoot
  • Milena Pavlova
  • Elka Atanasova
  • Wim Groot

Abstract

In 2010, a household survey was carried out in Hungary among 1037 respondents to study consumer preferences and willingness to pay for health care services. In this paper, we use the data from the discrete choice experiments included in the survey, to elicit the preferences of health care consumers about the choice of health care providers. Regression analysis is used to estimate the effect of the improvement of service attributes (quality, access, and price) on patients’ choice, as well as the differences among the socio-demographic groups. We also estimate the marginal willingness to pay for the improvement in attribute levels by calculating marginal rates of substitution. The results show that respondents from a village or the capital, with low education and bad health status are more driven by the changes in the price attribute when choosing between health care providers. Respondents value the good skills and reputation of the physician and the attitude of the personnel most, followed by modern equipment and maintenance of the office/hospital. Access attributes (travelling and waiting time) are less important. The method of discrete choice experiment is useful to reveal patients’ preferences, and might support the development of an evidence-based and sustainable health policy on patient payments.
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  • Thijs Schoot & Milena Pavlova & Elka Atanasova & Wim Groot, 2017. "Preferences of Bulgarian consumers for quality, access and price attributes of healthcare services—result of a discrete choice experiment," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(1), pages 47-71, January.
    • Handle: RePEc:bla:ijhplm:v:32:y:2017:i:1:p:e47-e71
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    1. Anna Merino, 2003. "Eliciting consumers preferences using stated preference discrete choice models: Contingent ranking versus choice experiment," Economics Working Papers 705, Department of Economics and Business, Universitat Pompeu Fabra.
    2. Anna Merino, 2003. "Eliciting consumers preferences using stated preference discrete choice models: Contingent ranking versus choice experiment," Working Papers, Research Center on Health and Economics 705, Department of Economics and Business, Universitat Pompeu Fabra.
    3. Elka Atanasova & Milena Pavlova & Emanuela Moutafova & Todorka Kostadinova & Wim Groot, 2012. "Patient payments and the empirical analysis of consumer demand for hospital services: An application for Bulgaria," Society and Economy, Akadémiai Kiadó, Hungary, vol. 34(2), pages 313-338, June.
    4. Thijs Schoot & Milena Pavlova & Elka Atanasova & Wim Groot, 2017. "Preferences of Bulgarian consumers for quality, access and price attributes of healthcare services—result of a discrete choice experiment," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(1), pages 47-71, January.
    5. Emily Lancsar & Jordan Louviere, 2008. "Conducting Discrete Choice Experiments to Inform Healthcare Decision Making," PharmacoEconomics, Springer, vol. 26(8), pages 661-677, August.
    6. Milena Pavlova & Wim Groot & Godefridus Merode, 2005. "An Application of Rating Conjoint Analysis to Study the Importance of Quality-, Access- and Price-attributes to Health Care Consumers," Economic Change and Restructuring, Springer, vol. 37(3), pages 267-286, September.
    7. Atanasova, Elka & Pavlova, Milena & Velickovski, Robert & Nikov, Bogomil & Moutafova, Emanuela & Groot, Wim, 2011. "What have 10 years of health insurance reforms brought about in Bulgaria? Re-appraising the Health Insurance Act of 1998," Health Policy, Elsevier, vol. 102(2), pages 263-269.
    8. Pavlova, Milena & Groot, Wim & van Merode, Frits, 2000. "Appraising the financial reform in Bulgarian public health care sector: the health insurance act of 1998," Health Policy, Elsevier, vol. 53(3), pages 185-199, October.
    9. Balabanova, Dina & McKee, Martin, 2002. "Understanding informal payments for health care: the example of Bulgaria," Health Policy, Elsevier, vol. 62(3), pages 243-273, December.
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    Cited by:

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    2. Angeli, Federica & Jaiswal, Anand Kumar & Shrivastava, Saumya, 2022. "Integrating poverty alleviation and environmental protection efforts: A socio-ecological perspective on menstrual health management," Social Science & Medicine, Elsevier, vol. 314(C).
    3. Nikolina Dukić Samaržija, 2019. "Determining the Marginal Willingness to Pay for the Cervical Cancer Screening Program in Croatia: A Best-Worst Scaling Approach," Society and Economy, Akadémiai Kiadó, Hungary, vol. 41(4), pages 433-447, December.
    4. Vikas Soekhai & Esther W. Bekker-Grob & Alan R. Ellis & Caroline M. Vass, 2019. "Discrete Choice Experiments in Health Economics: Past, Present and Future," PharmacoEconomics, Springer, vol. 37(2), pages 201-226, February.
    5. Thijs Schoot & Milena Pavlova & Elka Atanasova & Wim Groot, 2017. "Preferences of Bulgarian consumers for quality, access and price attributes of healthcare services—result of a discrete choice experiment," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(1), pages 47-71, January.
    6. Thiptaiya Sydavong & Daisaku Goto & Keisuke Kawata & Shinji Kaneko & Masaru Ichihashi, 2019. "Potential demand for voluntary community-based health insurance improvement in rural Lao People’s Democratic Republic: A randomized conjoint experiment," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-21, January.
    7. Óscar Brito Fernandes & Márta Péntek & Dionne Kringos & Niek Klazinga & László Gulácsi & Petra Baji, 2020. "Eliciting preferences for outpatient care experiences in Hungary: A discrete choice experiment with a national representative sample," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-15, July.
    8. Petra Baji & Milena Pavlova & László Gulácsi & Miklós Farkas & Wim Groot, 2014. "The link between past informal payments and willingness of the Hungarian population to pay formal fees for health care services: results from a contingent valuation study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 853-867, November.

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    More about this item

    JEL classification:

    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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