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Investigating consumers' and informal carers' views and preferences for consumer directed care: A discrete choice experiment

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  • Kaambwa, Billingsley
  • Lancsar, Emily
  • McCaffrey, Nicola
  • Chen, Gang
  • Gill, Liz
  • Cameron, Ian D.
  • Crotty, Maria
  • Ratcliffe, Julie

Abstract

Consumer directed care (CDC) is currently being embraced internationally as a means to promote autonomy and choice for consumers (people aged 65 and over) receiving community aged care services (CACSs). CDC involves giving CACS clients (consumers and informal carers of consumers) control over how CACSs are administered. However, CDC models have largely developed in the absence of evidence on clients' views and preferences. We explored CACS clients' preferences for a variety of CDC attributes and identified factors that may influence these preferences and potentially inform improved design of future CDC models. Study participants were clients of CACSs delivered by five Australian providers. Using a discrete choice experiment (DCE) approach undertaken in a group setting between June and December 2013, we investigated the relative importance to CACS consumers and informal (family) carers of gradations relating to six salient features of CDC (choice of service provider(s), budget management, saving unused/unspent funds, choice of support/care worker(s), support-worker flexibility and level of contact with service coordinator). The DCE data were analysed using conditional, mixed and generalised logit regression models, accounting for preference and scale heterogeneity. Mean ages for 117 study participants were 80 years (87 consumers) and 74 years (30 informal carers). All participants preferred a CDC approach that allowed them to: save unused funds from a CACS package for future use; have support workers that were flexible in terms of changing activities within their CACS care plan and; choose the support workers that provide their day-to-day CACSs. The CDC attributes found to be important to both consumers and informal carers receiving CACSs will inform the design of future CDC models of service delivery. The DCE approach used in this study has the potential for wide applicability and facilitates the assessment of preferences for elements of potential future aged care service delivery not yet available in policy.

Suggested Citation

  • Kaambwa, Billingsley & Lancsar, Emily & McCaffrey, Nicola & Chen, Gang & Gill, Liz & Cameron, Ian D. & Crotty, Maria & Ratcliffe, Julie, 2015. "Investigating consumers' and informal carers' views and preferences for consumer directed care: A discrete choice experiment," Social Science & Medicine, Elsevier, vol. 140(C), pages 81-94.
    • Handle: RePEc:eee:socmed:v:140:y:2015:i:c:p:81-94
    DOI: 10.1016/j.socscimed.2015.06.034
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    1. Milte, Rachel & Huynh, Elisabeth & Ratcliffe, Julie, 2019. "Assessing quality of care in nursing homes using discrete choice experiments: How does the level of cognitive functioning impact upon older people's preferences?," Social Science & Medicine, Elsevier, vol. 238(C), pages 1-1.
    2. Kaambwa, Billingsley & Chen, Gang & Khadka, Jyoti & Milte, Rachel & Mpundu-Kaambwa, Christine & Woods, Taylor-Jade & Ratcliffe, Julie, 2021. "A preference for quality: Australian general public's willingness to pay for home and residential aged care," Social Science & Medicine, Elsevier, vol. 289(C).
    3. Amilon, Anna & Ladenburg, Jacob & Siren, Anu & Vernstrøm Østergaard, Stine, 2020. "Willingness to pay for long-term home care services: Evidence from a stated preferences analysis," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    4. de Bresser, Jochem & Knoef, Marike & van Ooijen, Raun, 2022. "Preferences for in-kind and in-cash home care insurance," Journal of Health Economics, Elsevier, vol. 84(C).
    5. Rachel Milte & Julie Ratcliffe & Gang Chen & Michelle Miller & Maria Crotty, 2018. "Taste, choice and timing: Investigating resident and carer preferences for meals in aged care homes," Nursing & Health Sciences, John Wiley & Sons, vol. 20(1), pages 116-124, March.
    6. Chen, Gang & Ratcliffe, Julie & Milte, Rachel & Khadka, Jyoti & Kaambwa, Billingsley, 2021. "Quality of care experience in aged care: An Australia-Wide discrete choice experiment to elicit preference weights," Social Science & Medicine, Elsevier, vol. 289(C).
    7. Walsh, Sharon & O'Shea, Eamon & Pierse, Tom & Kennelly, Brendan & Keogh, Fiona & Doherty, Edel, 2020. "Public preferences for home care services for people with dementia: A discrete choice experiment on personhood," Social Science & Medicine, Elsevier, vol. 245(C).
    8. Song, Shan & Wang, De & Zhu, Wei & Wang, Can, 2020. "Study on the spatial configuration of nursing homes for the elderly people in Shanghai: Based on their choice preference," Technological Forecasting and Social Change, Elsevier, vol. 152(C).
    9. T. Lehnert & O. H. Günther & A. Hajek & S. G. Riedel-Heller & H. H. König, 2018. "Preferences for home- and community-based long-term care services in Germany: a discrete choice experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(9), pages 1213-1223, December.
    10. de Bresser, Jochem & Knoef, Marike & van Ooijen, Raun, 2021. "Preferences for In-Kind and In-Cash Home Care Insurance," Discussion Paper 2021-033, Tilburg University, Center for Economic Research.
    11. Billingsley Kaambwa & Julie Ratcliffe, 2018. "Predicting EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) Utilities from Older People’s Quality of Life Brief Questionnaire (OPQoL-Brief) Scores," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 11(1), pages 39-54, February.
    12. Tran, My (Michelle) & Gannon, Brenda, 2021. "The regional effect of the consumer directed care model for older people in Australia," Social Science & Medicine, Elsevier, vol. 280(C).
    13. de Bresser, Jochem & Knoef, Marike & van Ooijen, Raun, 2021. "Preferences for In-Kind and In-Cash Home Care Insurance," Other publications TiSEM fca83bd4-09cc-4072-81c6-0, Tilburg University, School of Economics and Management.
    14. My (Michelle) Tran & Brenda Gannon, 2020. "Home Care Providers in Queensland: Exploratory Data Analysis Using My Aged Care Platform," Australian Economic Review, The University of Melbourne, Melbourne Institute of Applied Economic and Social Research, vol. 53(4), pages 598-604, December.
    15. Amilon, Anna & Kjær, Agnete Aslaug & Ladenburg, Jacob & Siren, Anu, 2022. "Trust in the publicly financed care system and willingness to pay for long-term care: A discrete choice experiment in Denmark," Social Science & Medicine, Elsevier, vol. 311(C).
    16. Lea de Jong & Jan Zeidler & Kathrin Damm, 2022. "A systematic review to identify the use of stated preference research in the field of older adult care," European Journal of Ageing, Springer, vol. 19(4), pages 1005-1056, December.

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