Constrained latent class analysis: Simultaneous classification and scaling of discrete choice data

Psychometrika ◽  
1991 ◽  
Vol 56 (4) ◽  
pp. 699-716 ◽  
Author(s):  
Ulf Böckenholt ◽  
Ingo Böckenholt
Keyword(s):  
Latent Class Analysis ◽  
Discrete Choice ◽  
Latent Class ◽  
Class Analysis ◽  
Choice Data

scholarly journals Incentivising doctor attendance in rural Bangladesh: a latent class analysis of a discrete choice experiment

2021 ◽  
Vol 6 (7) ◽  
pp. e006001
Author(s):  
Blake Angell ◽  
Mushtaq Khan ◽  
Raihanul Islam ◽  
Kate Mandeville ◽  
Nahitun Naher ◽  
...  
Keyword(s):  
Latent Class Analysis ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class ◽  
Latent Class Models ◽  
Class Analysis ◽  
Sustainable Solutions ◽  
Rural Bangladesh ◽  
Incentive Payments

ObjectiveDoctor absenteeism is widespread in Bangladesh, and the perspectives of the actors involved are insufficiently understood. This paper sought to elicit preferences of doctors over aspects of jobs in rural areas in Bangladesh that can help to inform the development of packages of policy interventions that may persuade them to stay at their posts.MethodsWe conducted a discrete choice experiment with 308 doctors across four hospitals in Dhaka, Bangladesh. Four attributes of rural postings were included based on a literature review, qualitative research and a consensus-building workshop with policymakers and key health-system stakeholders: relationship with the community, security measures, attendance-based policies and incentive payments. Respondents’ choices were analysed with mixed multinomial logistic and latent class models and were used to simulate the likely uptake of jobs under different policy packages.ResultsAll attributes significantly impacted doctor choices (p<0.01). Doctors strongly preferred jobs at rural facilities where there was a supportive relationship with the community (β=0.93), considered good attendance in education and training (0.77) or promotion decisions (0.67), with functional security (0.67) and higher incentive payments (0.5 per 10% increase of base salary). Jobs with disciplinary action for poor attendance were disliked by respondents (−0.63). Latent class analysis identified three groups of doctors who differed in their uptake of jobs. Scenario modelling identified intervention packages that differentially impacted doctor behaviour and combinations that could feasibly improve doctors’ attendance.ConclusionBangladeshi doctors have strong but varied preferences over interventions to overcome absenteeism. We generated evidence suggesting that interventions considering the perspective of the doctors themselves could result in substantial reductions in absenteeism. Designing policy packages that take account of the different situations facing doctors could begin to improve their ability and motivation to be present at their job and generate sustainable solutions to absenteeism in rural Bangladesh.

scholarly journals Should I Stay or Should I Go Home? A Latent Class Analysis of a Discrete Choice Experiment on Hospital-At-Home

2014 ◽  
Vol 17 (5) ◽  
pp. 588-596 ◽  
Author(s):  
Lucas M.A. Goossens ◽  
Cecile M.A. Utens ◽  
Frank W.J.M. Smeenk ◽  
Bas Donkers ◽  
Onno C.P. van Schayck ◽  
...  
Keyword(s):  
Latent Class Analysis ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class ◽  
Class Analysis ◽  
Hospital At Home ◽  
At Home

scholarly journals How to incentivise doctor attendance in Bangladesh: a latent class analysis of a discrete choice experiment

2021 ◽  
Author(s):  
Blake Angell ◽  
Mushtaq Khan ◽  
Mir Raihanul Islam ◽  
Kate Mandeville ◽  
Nahitun Naher ◽  
...  
Keyword(s):  
Latent Class Analysis ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class ◽  
Latent Class Models ◽  
Disciplinary Action ◽  
Class Analysis ◽  
Sustainable Solutions ◽  
Incentive Payments

AbstractObjectiveTo elicit preferences of doctors over interventions to address doctor absenteeism in rural facilities in Bangladesh, a pervasive form of corruption across the country.MethodsWe conducted a discrete choice experiment with 308 doctors across four tertiary hospitals in Dhaka, Bangladesh. Four attributes of rural postings were included based on a literature review, qualitative research and a consensus-building workshop with policymakers and key health-system stakeholders: relationship with the community, security measures, attendance-based policies, and incentive payments. Respondents’ choices were analysed with mixed multinomial logistic and latent class models and were used to simulate the likely uptake of jobs under different policy packages.ResultsAll attributes significantly impacted doctor choices (p<0.01). Doctors strongly preferred jobs at rural facilities where there was a supportive relationship with the community (β=0.93), considered good attendance in education and training (0.77) or promotion decisions (0.67), with functional security (0.67) and higher incentive payments (0.5 per 10% increase of base salary). Jobs with disciplinary action for poor attendance were disliked by respondents (-.63). Latent class analysis identified three groups of doctors that differed in their uptake of jobs. Scenario modelling identified intervention packages that differentially impacted doctor behaciour and combinations that could feasibly improve doctors’ attendance.ConclusionBangladeshi doctors have strong but varied preferences over interventions to overcome absenteeism. Some were unresponsive to intervention but a substantial number appear amenable to change. Designing policy packages that consider these differences and target particular doctors could begin to generate sustainable solutions to doctor absenteeism in rural Bangladesh.

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