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Preferences for hospital quality in Zambia: results from a discrete choice experiment

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  • Kara Hanson
  • Barbara McPake
  • Pamela Nakamba
  • Luke Archard

Abstract

This study reports on the results of a discrete choice experiment undertaken in Zambia to assess the factors influencing the demand for hospital care in Zambia, in particular the role of (perceived) quality and trade‐offs between price and quality. Valuations of quality were evaluated for the treatment of two acute medical conditions, cerebral malaria in adults and acute pneumonia in children. Marginal utilities and willingness‐to‐pay for attributes of quality of hospital care were estimated, together with the influence of socioeconomic characteristics on these valuations and the extent of non‐linearities in valuations of time and money. We find the technical quality of care, as represented by the thoroughness of examination, to be the most important quality attribute, followed by staff attitudes and drug availability. Valuations of examination thoroughness increase with increasing socioeconomic status. The disutility of cost was found to decrease with higher socioeconomic status, as was the value of drug availability. The implications of the findings for Zambian hospital sector reforms are discussed. Copyright © 2004 John Wiley & Sons, Ltd.

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  • Kara Hanson & Barbara McPake & Pamela Nakamba & Luke Archard, 2005. "Preferences for hospital quality in Zambia: results from a discrete choice experiment," Health Economics, John Wiley & Sons, Ltd., vol. 14(7), pages 687-701, July.
    • Handle: RePEc:wly:hlthec:v:14:y:2005:i:7:p:687-701
    DOI: 10.1002/hec.959
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    3. Mehmet Kutluay & Roy Brouwer & Haripriya Gundimeda & Nitin Lokhande & Richard S. J. Tol, 2017. "Public preferences and valuation of new malaria risk," Working Paper Series 1917, Department of Economics, University of Sussex Business School.
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    7. Abiiro, Gilbert Abotisem & Torbica, Aleksandra & Kwalamasa, Kassim & De Allegri, Manuela, 2014. "Eliciting community preferences for complementary micro health insurance: A discrete choice experiment in rural Malawi," Social Science & Medicine, Elsevier, vol. 120(C), pages 160-168.
    8. Caroline Vass & Dan Rigby & Katherine Payne, 2017. "The Role of Qualitative Research Methods in Discrete Choice Experiments," Medical Decision Making, , vol. 37(3), pages 298-313, April.
    9. Zachary Wagner & Somalee Banerjee & Manoj Mohanan & Neeraj Sood, 2023. "Does the market reward quality? Evidence from India," International Journal of Health Economics and Management, Springer, vol. 23(3), pages 467-505, September.
    10. Richard Cookson & Diane Dawson, 2012. "Hospital Competition and Patient Choice in Publicly Funded Health Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 20, Edward Elgar Publishing.
    11. Shomikho Raha & Peter Berman & Aarushi Bhatnagar, 2009. "Career Preferences of Medical and Nursing Students in Uttar Pradesh," World Bank Publications - Reports 12836, The World Bank Group.
    12. Baert, Midas & Kervyn, Matthieu & Kagou, Armand Dongmo & Guedjeo, Christian Suh & Vranken, Liesbet & Mertens, Kewan, 2020. "Resettlement preferences from landslide prone areas in Cameroon: Willingness to move, reasons to stay," Land Use Policy, Elsevier, vol. 95(C).
    13. Hole, Arne Risa, 2008. "Modelling heterogeneity in patients' preferences for the attributes of a general practitioner appointment," Journal of Health Economics, Elsevier, vol. 27(4), pages 1078-1094, July.
    14. Michael J. Barrowclough & Jeffrey Alwang, 2018. "Conservation agriculture in Ecuador’s highlands: a discrete choice experiment," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 20(6), pages 2681-2705, December.
    15. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    16. Kruk, Margaret E. & Rockers, Peter C. & Mbaruku, Godfrey & Paczkowski, Magdalena M. & Galea, Sandro, 2010. "Community and health system factors associated with facility delivery in rural Tanzania: A multilevel analysis," Health Policy, Elsevier, vol. 97(2-3), pages 209-216, October.
    17. Emily Lancsar & Peter Burge, 2014. "Choice modelling research in health economics," Chapters, in: Stephane Hess & Andrew Daly (ed.), Handbook of Choice Modelling, chapter 28, pages 675-687, Edward Elgar Publishing.
    18. Jeff Bennett & Ekin Birol, 2010. "Introduction: The Roles and Significance of Choice Experiments in Developing Country Contexts," Chapters, in: Jeff Bennett & Ekin Birol (ed.), Choice Experiments in Developing Countries, chapter 1, Edward Elgar Publishing.

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