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Using discrete choice experiments to measure preferences for hard to observe choice attributes to inform health policy decisions


  • Eline Broek-Altenburg

    (University of Vermont)

  • Adam Atherly

    (University of Vermont)


Background Models of preferences in health services research (HSR) and Health Economics are often defined by readily available information, such as that captured in claims data and electronic health records. Yet many important questions about patient choices cannot be easily studied because of a lack of critical data elements. The objective of this review is to outline the advantages of using stated preferences (SP) data in health services research, and to outline how these methods can be used to evaluate choices that have not yet been offered or studied. Main body This article focuses on the application of DCE’s to relevant policy and health system delivery questions currently relevant, particularly in the United States. DCE’s may be helpful to collect data from patient or consumer data that we currently do not have. The article provides examples of research questions that have been answered using SP data collected with a DCE. It outlines how to construct a DCE and how to analyze the data. It also discusses the methodological challenges and emphasizes important considerations regarding the design and estimation methods. SP data can be adopted in situations where we would like to have consumer choice data, but we currently do not. These are often hypothetical situations to analyze the decision-making process of individuals. With SP data it is possible to analyze trade-offs patients make when choosing between treatment options where these hard to measure attributes are important. Conclusion This paper emphasizes that a carefully designed DCE and appropriate estimation methods can open up a new world of data regarding trade-offs patients and providers in healthcare are willing to make. It updates previous “how to” guide for DCE’s for health services researchers and health economists who are not familiar with these methods or have been unwilling to use them and updates previous description of these methods with timely examples.

Suggested Citation

  • Eline Broek-Altenburg & Adam Atherly, 2020. "Using discrete choice experiments to measure preferences for hard to observe choice attributes to inform health policy decisions," Health Economics Review, Springer, vol. 10(1), pages 1-8, December.
  • Handle: RePEc:spr:hecrev:v:10:y:2020:i:1:d:10.1186_s13561-020-00276-x
    DOI: 10.1186/s13561-020-00276-x

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    References listed on IDEAS

    1. Nick Hanley & Robert Wright & Vic Adamowicz, 1998. "Using Choice Experiments to Value the Environment," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 11(3), pages 413-428, April.
    2. Berinsky, Adam J. & Huber, Gregory A. & Lenz, Gabriel S., 2012. "Evaluating Online Labor Markets for Experimental Research:'s Mechanical Turk," Political Analysis, Cambridge University Press, vol. 20(3), pages 351-368, July.
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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 6th July 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-07-06 11:00:00


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    1. Smeele, Nicholas V.R. & Chorus, Caspar G. & Schermer, Maartje H.N. & de Bekker-Grob, Esther W., 2023. "Towards machine learning for moral choice analysis in health economics: A literature review and research agenda," Social Science & Medicine, Elsevier, vol. 326(C).
    2. Wang, Sophie Y. & Cantarelli, Paola & Groene, Oliver & Stargardt, Tom & Belle, Nicola, 2023. "Patient expectations do matter - Experimental evidence on antibiotic prescribing decisions among hospital-based physicians," Health Policy, Elsevier, vol. 128(C), pages 11-17.

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