Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/21137
Appears in Collections:Economics Journal Articles
Peer Review Status: Refereed
Title: Prioritising Health Service Innovation Investments Using Public Preferences: A Discrete Choice Experiment
Authors: Erdem, Seda
Thompson, Carl
Contact Email: seda.erdem@stir.ac.uk
Issue Date: 10-Aug-2014
Publisher: BioMed Central
Citation: Erdem S & Thompson C (2014) Prioritising Health Service Innovation Investments Using Public Preferences: A Discrete Choice Experiment, BMC Health Services Research, 14, Art. No.: 360.
Abstract: Background: Prioritising scarce resources for investment in innovation by publically funded health systems is unavoidable. Many healthcare systems wish to foster transparency and accountability in the decisions they make by incorporating the public in decision-making processes. This paper presents a unique conceptual approach exploring the public's preferences for health service innovations by viewing healthcare innovations as 'bundles' of characteristics. This decompositional approach allows policy-makers to compare numerous competing health service innovations without repeatedly administering surveys for specific innovation choices. Methods: A Discrete Choice Experiment (DCE) was used to elicit preferences. Individuals chose from presented innovation options that they believe the UK National Health Service (NHS) should invest the most in. Innovations differed according to: (i) target population; (ii) target age; (iii) implementation time; (iv) uncertainty associated with their likely effects; (v) potential health benefits; and, (vi) cost to a taxpayer. This approach fosters multidimensional decision-making, rather than imposing a single decision criterion (e.g., cost, target age) in prioritisation. Choice data was then analysed using scale-adjusted Latent Class models to investigate variability in preferences and scale and valuations amongst respondents. Results: Three latent classes with considerable heterogeneity in the preferences were present. Each latent class is composed of two consumer subgroups varying in the level of certainty in their choices. All groups preferred scientifically proven innovations, those with potential health benefits that cost less. There were, however, some important differences in their preferences for innovation investment choices: Class-1 (54%) prefers innovations benefitting adults and young people and does not prefer innovations targeting people with 'drug addiction' and 'obesity'. Class- 2 (34%) prefers innovations targeting 'cancer' patients only and has negative preferences for innovations targeting elderly, and Class-3 (12%) prefers spending on elderly and cancer patients the most. Conclusions: DCE can help policy-makers incorporate public preferences for health service innovation investment choices into decision making. The findings provide useful information on the public's valuation and acceptability of potential health service innovations. Such information can be used to guide innovation prioritisation decisions by comparing competing innovation options. The approach in this paper makes, these often implicit and opaque decisions, more transparent and explicit.
Type: Journal Article
URI: http://hdl.handle.net/1893/21137
DOI Link: http://dx.doi.org/10.1186/1472-6963-14-360
Rights: © 2014 Erdem and Thompson; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
Affiliation: Economics
University of York

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