Quality of care experience in aged care: An Australia-Wide discrete choice experiment to elicit preference weights

2021 ◽  
pp. 114440
Author(s):  
Gang Chen ◽  
Julie Ratcliffe ◽  
Rachel Milte ◽  
Jyoti Khadka ◽  
Billingsley Kaambwa
Keyword(s):  
Quality Of Care ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Aged Care ◽  
Care Experience ◽  
Preference Weights

scholarly journals Understanding what women want: eliciting preference for delivery health facility in a rural subcounty in Kenya, a discrete choice experiment

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038865
Author(s):  
Jackline Oluoch-Aridi ◽  
Mary B Adam ◽  
Francis Wafula ◽  
Gilbert Kokwaro
Keyword(s):  
Quality Of Care ◽  
Health Facility ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Home Delivery ◽  
Process Indicator ◽  
Opt Out ◽  
Women’S Preferences

ObjectiveTo identify what women want in a delivery health facility and how they rank the attributes that influence the choice of a place of delivery.DesignA discrete choice experiment (DCE) was conducted to elicit rural women’s preferences for choice of delivery health facility. Data were analysed using a conditional logit model to evaluate the relative importance of the selected attributes. A mixed multinomial model evaluated how interactions with sociodemographic variables influence the choice of the selected attributes.SettingSix health facilities in a rural subcounty.ParticipantsWomen aged 18–49 years who had delivered within 6 weeks.Primary outcomeThe DCE required women to select from hypothetical health facility A or B or opt-out alternative.ResultsA total of 474 participants were sampled, 466 participants completed the survey (response rate 98%). The attribute with the strongest association with health facility preference was having a kind and supportive healthcare worker (β=1.184, p<0.001), second availability of medical equipment and drug supplies (β=1.073, p<0.001) and third quality of clinical services (β=0.826, p<0.001). Distance, availability of referral services and costs were ranked fourth, fifth and sixth, respectively (β=0.457, p<0.001; β=0.266, p<0.001; and β=0.000018, p<0.001). The opt-out alternative ranked last suggesting a disutility for home delivery (β=−0.849, p<0.001).ConclusionThe most highly valued attribute was a process indicator of quality of care followed by technical indicators. Policymakers need to consider women’s preferences to inform strategies that are person centred and lead to improvements in quality of care during delivery.

scholarly journals Experts’ preferences for sarcopenia outcomes: a discrete-choice experiment from a working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) in collaboration with the European Union of Geriatric Medicine Society (EUGMS)

2021 ◽  
Author(s):  
Charlotte Beaudart ◽  
◽  
Jürgen M. Bauer ◽  
Francesco Landi ◽  
Olivier Bruyère ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Musculoskeletal Diseases ◽  
Geriatric Medicine ◽  
Mixed Logit ◽  
The European Union ◽  
Domestic Activities

Abstract Background and aims To assess experts’ preference for sarcopenia outcomes. Methods A discrete-choice experiment was conducted among 37 experts (medical doctors and researchers) from different countries around the world. In the survey, they were repetitively asked to choose which one of two hypothetical patients suffering from sarcopenia deserves the most a treatment. The two hypothetical patients differed in five pre-selected sarcopenia outcomes: quality of life, mobility, domestic activities, fatigue and falls. A mixed logit panel model was used to estimate the relative importance of each attribute. Results All sarcopenia outcomes were shown to be significant, and thus, important for experts. Overall, the most important sarcopenia outcome was falls (27%) followed by domestic activities and mobility (24%), quality of life (15%) and fatigue (10%). Discussion and conclusion Compared to patient’s preferences, experts considered falls as a more important outcome of sarcopenia, while the outcomes fatigue and difficulties in domestic activities were considered as less important.

scholarly journals Do Patient Preferences Align With Value Frameworks? A Discrete-Choice Experiment of Patients With Breast Cancer

2020 ◽  
Vol 5 (1) ◽  
pp. 238146832092801
Author(s):  
Ilene L. Hollin ◽  
Juan Marcos González ◽  
Lisabeth Buelt ◽  
Michael Ciarametaro ◽  
Robert W. Dubois
Keyword(s):  
Breast Cancer ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Treatment Efficacy ◽  
Choice Experiment ◽  
Route Of Administration ◽  
Systematic Evaluation ◽  
Individual Level ◽  
Preference Weights

Purpose. Assess patient preferences for aspects of breast cancer treatments to evaluate and inform the usual assumptions in scoring rubrics for value frameworks. Methods. A discrete-choice experiment (DCE) was designed and implemented to collect quantitative evidence on preferences from 100 adult female patients with a self-reported physician diagnosis of stage 3 or stage 4 breast cancer. Respondents were asked to evaluate some of the treatment aspects currently considered in value frameworks. Respondents’ choices were analyzed using logit-based regression models that produced preference weights for each treatment aspect considered. Aggregate- and individual-level preferences were used to assess the relative importance of treatment aspects and their variability across respondents. Results. As expected, better clinical outcomes were associated with higher preference weights. While life extensions with treatment were considered to be most important, respondents assigned great value to out-of-pocket cost of treatment, treatment route of administration, and the availability of reliable tests to help gauge treatment efficacy. Two respondent classes were identified in the sample. Differences in class-specific preferences were primarily associated with route of administration, out-of-pocket treatment cost, and the availability of a test to gauge treatment efficacy. Only patient cancer stage was found to be correlated with class assignment ( P = 0.035). Given the distribution of individual-level preference estimates, preference for survival benefits are unlikely to be adequately described with two sets of preference weights. Conclusions. Although value frameworks are an important step in the systematic evaluation of medications in the context of a complex treatment landscape, the frameworks are still largely driven by expert judgment. Our results illustrate issues with this approach as patient preferences can be heterogeneous and different from the scoring weights currently provided by the frameworks.

Investigating the relative value of health and social care related quality of life using a discrete choice experiment

2019 ◽  
Vol 233 ◽  
pp. 28-37 ◽  
Author(s):  
Brendan Mulhern ◽  
Richard Norman ◽  
Richard De Abreu Lourenco ◽  
Juliette Malley ◽  
Deborah Street ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Social Care ◽  
Relative Value ◽  
Health And Social Care ◽  
Related Quality ◽  
Value Of Health

scholarly journals Dear policy maker: Have you made up your mind? A discrete choice experiment among policy makers and other health professionals

2010 ◽  
Vol 26 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Marc A. Koopmanschap ◽  
Elly A. Stolk ◽  
Xander Koolman
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Disease Severity ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Healthcare Professionals ◽  
Budget Impact ◽  
Policy Makers

Objectives: The aim of this study was to get insight in what criteria as presented in Health technology assessment (HTA) studies are important for decision makers in healthcare priority setting.Methods: We performed a discrete choice experiment among Dutch healthcare professionals (policy makers, HTA experts, advanced HTA students). In twenty-seven choice sets, we asked respondents to elect reimbursement of one of two different healthcare interventions, which represented unlabeled, curative treatments. Both treatments were incrementally compared with usual care. The results of the interventions were normal outputs of HTA studies with a societal perspective. Results were analyzed using a multinomial logistic regression model. Upon completion of the questionnaire, we discussed the exercise with policy makers.Results: Severity of disease, costs per quality-adjusted life-year gained, individual health gain, and the budget impact were the most decisive decision criteria. A program targeting more severe diseases increased the probability of reimbursement dramatically. Uncertainty related to cost-effectiveness was also important. Respondents preferred health gains that include quality of life improvements over extension of life without improved quality of life. Savings in productivity costs were not crucial in decision making, although these are to be included in Dutch reimbursement dossiers for new drugs. Regarding subgroups, we found that policy makers attached relatively more weight to disease severity than others but less to uncertainty.Conclusions: Dutch policy makers and other healthcare professionals seem to have reasonably well articulated preferences: six of seven attributes were significant. Disease severity, budget impact, and cost-effectiveness were very important. The results are comparable to international studies, but reveal a larger set of important decision criteria.

scholarly journals Calculating Preference Weights for the Labor and Delivery Index: A Discrete Choice Experiment on Women’s Birth Experiences

2015 ◽  
Vol 18 (6) ◽  
pp. 856-864 ◽  
Author(s):  
Fania R. Gärtner ◽  
Esther W. de Bekker-Grob ◽  
Anne M. Stiggelbout ◽  
Marlies E. Rijnders ◽  
Liv M. Freeman ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Labor And Delivery ◽  
Preference Weights

scholarly journals Using a Discrete-Choice Experiment Involving Cost to Value a Classification System Measuring the Quality-of-Life Impact of Self-Management for Diabetes

2018 ◽  
Vol 21 (1) ◽  
pp. 69-77 ◽  
Author(s):  
Donna Rowen ◽  
Katherine Stevens ◽  
Alexander Labeit ◽  
Jackie Elliott ◽  
Brendan Mulhern ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Classification System ◽  
Choice Experiment ◽  
Self Management ◽  
Life Impact

Caregiver preferences for increasing patient survival in advanced melanoma.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 185-185
Author(s):  
A. Brett Hauber ◽  
Juan M. González ◽  
Joshua Posner ◽  
Michael Lees
Keyword(s):  
Survival Time ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Symptom Severity ◽  
Choice Experiment ◽  
Standard Of Care ◽  
Advanced Melanoma ◽  
Severe Nausea ◽  
Incremental Value

185 Background: Patients with advanced cancer and their caregivers may often accept shorter life expectancy to ensure higher quality of remaining months of life. Our objective was to elicit caregiver preferences for quality-adjusted survival associated with treatments for advanced melanoma using a discrete-choice experiment. Methods: Adults in Germany and Sweden caring for people with diagnoses of advanced melanoma completed a web-enabled, discrete-choice experiment. The survey presented caregivers with a series of 10 choice questions, each including three profiles – a pair of hypothetical melanoma treatments and standard of care. Each profile was defined by survival time (24 months, 12 months, 6 months), severity (mild, moderate, severe) of melanoma symptoms, nausea and vomiting, diarrhea, skin problems, and out-of-pocket cost. Treatment profile pairs in choice questions were based on an experimental design with known statistical properties. Standard of care was constant across all choice questions. Regression analysis related respondents’ choice to treatment characteristics and estimate preference weights in each country. Results: 188 respondents in Germany and 202 in Sweden completed the survey. Caregivers choices were consistent with accepting tradeoffs among efficacy, symptom severity, severity of toxicities and cost. Severity of melanoma symptoms was the most important outcome for Swedish caregivers and was approximately as important as survival time for German caregivers. German caregivers placed positive value on each additional month of survival regardless of symptom severity. In Sweden, additional months of survival were of positive value to caregivers except when melanoma symptoms were severe or patients experienced severe nausea, vomiting, and diarrhea concurrently. In all cases where additional months of survival had positive value, the incremental value of each additional month diminished as overall survival increased. Conclusions: Additional months of life with severe symptoms or toxicities may not be viewed as unambiguously good outcomes. Quality of survival is not only a key consideration, but may determine whether a given treatment for melanoma is considered better or worse than standard of care.

Sign in / Sign up

Export Citation Format

Share Document