scholarly journals Use of Lotteries for the Promotion of Voluntary Medical Male Circumcision Service: A Discrete-Choice Experiment among Adult Men in Tanzania

2019 ◽  
Vol 39 (4) ◽  
pp. 474-485 ◽  
Author(s):  
Jason J. Ong ◽  
Nyasule Neke ◽  
Mwita Wambura ◽  
Evodius Kuringe ◽  
Jonathan M. Grund ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Male Circumcision ◽  
Choice Experiment ◽  
Latent Class ◽  
Individual Preference ◽  
Preference Heterogeneity ◽  
Voluntary Medical Male Circumcision ◽  
Lottery Ticket ◽  
Medical Male Circumcision

Voluntary medical male circumcision (VMMC) is effective in reducing the risk of human immunodeficiency virus (HIV). However, countries like Tanzania have high HIV prevalence but low uptake of VMMC. We conducted a discrete-choice experiment to evaluate the preferences for VMMC service attributes in a random sample of 325 men aged 18 years or older from the general population in 2 Tanzanian districts, Njombe and Tabora. We examined the preference for financial incentives in the form of a lottery ticket or receiving a guaranteed transport voucher for attendance at a VMMC service. We created a random-parameters logit model to account for individual preference heterogeneity and a latent class analysis model for identifying groups of men with similar preferences to test the hypothesis that men who reported sexually risky behaviors (i.e., multiple partners and any condomless sex in the past 12 months) may have a preference for participation in a lottery-based incentive. Most men preferred a transport voucher (84%) over a lottery ticket. We also found that offering a lottery-based financial incentive may not differentially attract those with greater sexual risk. Our study highlights the importance of gathering local data to understand preference heterogeneity, particularly regarding assumptions around risk behaviors.

scholarly journals What Aspects of Illness Influence Public Preferences for Healthcare Priority Setting? A Discrete Choice Experiment in the UK

2021 ◽  
Author(s):  
Liz Morrell ◽  
James Buchanan ◽  
Sian Rees ◽  
Richard W. Barker ◽  
Sarah Wordsworth
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class ◽  
Conditional Logistic Regression ◽  
Health Gain ◽  
Assessment Process ◽  
Health Conditions ◽  
Preference Heterogeneity ◽  
The Uk

Abstract Background Decisions on funding new healthcare technologies assume that all health improvements are valued equally. However, public reaction to health technology assessment (HTA) decisions suggests there are health attributes that matter deeply to them but are not currently accounted for in the assessment process. We aimed to determine the relative importance of attributes of illness that influence the value placed on alleviating that illness. Method We conducted a discrete choice experiment survey that presented general public respondents with 15 funding decisions between hypothetical health conditions. The conditions were defined by five attributes that characterise serious illnesses, plus the health gain from treatment. Respondent preferences were modelled using conditional logistic regression and latent class analysis. Results 905 members of the UK public completed the survey in November 2017. Respondents generally preferred to provide treatments for conditions with ‘better’ characteristics. The exception was treatment availability, where respondents preferred to provide treatments for conditions where there is no current treatment, and were prepared to accept lower overall health gain to do so. A subgroup of respondents preferred to prioritise ‘worse’ health states. Conclusion This study suggests a preference among the UK public for treating an unmet need; however, it does not suggest a preference for prioritising other distressing aspects of health conditions, such as limited life expectancy, or where patients are reliant on care. Our results are not consistent with the features currently prioritised in UK HTA processes, and the preference heterogeneity we identify presents a major challenge for developing broadly acceptable policy.

Patients’, healthcare providers’, and health insurance employees’ preferences for knee and hip osteoarthritis care: a discrete choice experiment

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711305
Author(s):  
Ilgin Arslan ◽  
Samare Huls ◽  
Esther de Bekker-Grob ◽  
Rianne Rozendaal ◽  
Sita Bierma-Zeinstra ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class ◽  
Healthcare Providers ◽  
Hip Osteoarthritis ◽  
Preference Heterogeneity ◽  
Trade Offs ◽  
Wide Range ◽  
Out Of Pocket Costs

BackgroundDespite the wide range of treatment options for knee and hip osteoarthritis (KHOA), suboptimal care, low uptake and low adherence to treatment is widely seen. We need to gain insight into preferences for KHOA treatment.AimTo determine patients’, healthcare providers’ and healthcare insurance employees’ preferences for existing health care for KHOA.MethodA survey containing a discrete choice experiment (DCE) was conducted. Patients with KHOA, healthcare providers (orthopaedists and GPs), and insurance employees had to choose scenarios that differed in six attributes: waiting times, out of pocket costs, travel distance, involved healthcare providers during consultation, length of consultation and access to specialist equipment. A (panel latent class) conditional logit model was used to determine the relative importance of the attributes and trade-offs that responders made, and to explore preference heterogeneity.ResultsA total of 648 patients completed the DCE. All six attributes played a significant role in patients’ choices. On average, out of pocket costs were deemed undesirable by patients. A GP with an orthopaedist during the consultation was preferred compared to a GP alone. Healthcare providers (n = 76) and insurance employees (n = 150) showed similar preferences, with respect to out of pockets costs being valued less important. Latent class analysis identified four classes of patients varying in their preferences.ConclusionPatients prefer less out of pocket costs and a GP with an orthopedists during consultation for KHOA care. Four subgroups of patients were identified that vary in preferences for KHOA care. These subgroups could provide opportunities to improve uptake, adherence and effectiveness of KHOA care.

scholarly journals Job preferences of undergraduate pharmacy students in China: a discrete choice experiment

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ping Liu ◽  
Shimeng Liu ◽  
Tiantian Gong ◽  
Quan Li ◽  
Gang Chen ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Rural Areas ◽  
Choice Experiment ◽  
Job Characteristics ◽  
Pharmacy Students ◽  
Preference Heterogeneity ◽  
Short Supply ◽  
Job Preferences ◽  
Open Management

Abstract Background Pharmacists are a crucial part of the health workforce and play an important role in achieving universal health coverage. In China, pharmaceutical human resources are in short supply, and the distribution is unequal. This study aimed to identify the key job characteristics that influence the job preferences of undergraduate pharmacy students and to elicit the relative importance of different job characteristics to shed light on future policy interventions. Methods A discrete choice experiment was conducted to assess the job preferences of undergraduate pharmacy students from 6 provinces in mainland China. A face-to-face interview was used to collect data. Conditional logit and mixed logit models were used to analyse data, and the final model was chosen according to the model fit statistics. A series of policy simulations was also conducted. Results In total, 581 respondents completed the questionnaire, and 500 respondents who passed the internal consistency test were analysed. All attributes were statistically significant except for open management. Monthly income and work location were most important to respondents, followed by work unit (which refers to the nature of the workplace) and years to promotion. There was preference heterogeneity among respondents, e.g., male students preferred open management, and female students preferred jobs in public institutions. Furthermore, students with an urban background or from a single-child family placed higher value on a job in the city compared to their counterparts. Conclusion The heterogeneity of attributes showed the complexity of job preferences. Both monetary and nonmonetary job characteristics significantly influenced the job preferences of pharmacy students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both incentives on the job itself and the background of pharmacy school graduates.

Is “Localness” about Distance or Relationships? Evidence from Hard Cider

2019 ◽  
Vol 14 (3) ◽  
pp. 252-273 ◽  
Author(s):  
Jarrad Farris ◽  
Trey Malone ◽  
Lindon J. Robison ◽  
Nikki L. Rothwell
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class ◽  
Consumer Preferences ◽  
Geographic Distance ◽  
Social Capital Theory ◽  
The State ◽  
Travel Distance ◽  
Local Foods

AbstractWhile many studies have evaluated consumer demand for local foods, fewer studies have focused on the mechanism that has created the positive willingness-to-pay for local foods. This article compares the role of geographic distance and attachment value in consumer preferences for locally produced hard cider. Consumer valuations are estimated via a “branded” discrete choice experiment where the respondents chose between an in-state hard cider, an out-of-state hard cider, and a no buy option. Our measure of travel distance is based on the optimal driving route between each consumer's GPS location and the locations of the cideries while our attachment value measure is based on social capital theory. This allows us to analyze individual-specific travel distance heterogeneity in consumer choice as it relates to attachment value. Based on a latent class logit model estimated from a discrete choice experiment with 441 participants, we show that attachment value is higher for a cider produced within the state than for a cider produced outside the state. Furthermore, we show that increases in attachment value increase demand for locally produced hard cider more than an equal increase in attachment value for non-locally produced hard cider. Our findings are consistent with “local” preferences based on geopolitical boundaries (e.g., the state of Michigan) and not distance. (JEL Classifications: B55, M3, Q13, C83)

scholarly journals A protocol for a discrete choice experiment: understanding preferences of patients with cancer towards their cancer care across metropolitan and rural regions in Australia

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e006661 ◽  
Author(s):  
Shu Fen Wong ◽  
Richard Norman ◽  
Trisha L Dunning ◽  
David M Ashley ◽  
Paula K Lorgelly
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Cancer Care ◽  
Choice Experiment ◽  
Fractional Factorial ◽  
Medical Decision ◽  
Preference Heterogeneity ◽  
Related Factors ◽  
Patients With Cancer ◽  
Clinical Scenarios

IntroductionMedical decision-making in oncology is a complicated process and to date there are few studies examining how patients with cancer make choices with respect to different features of their care. It is also unknown whether patient choices vary by geographical location and how location could account for observed rural and metropolitan cancer differences. This paper describes an ongoing study that aims to (1) examine patient and healthcare-related factors that influence choices of patients with cancer; (2) measure and quantify preferences of patients with cancer towards cancer care using a discrete choice experiment (DCE) and (3) explore preference heterogeneity between metropolitan and rural locations.Methods and analysisA DCE is being conducted to understand how patients with cancer choose between two clinical scenarios accounting for different patient and healthcare-related factors (and levels). Preliminary qualitative research was undertaken to guide the development of an appropriate DCE design including characteristics that are important and relevant to patients with cancer. A fractional factorial design using the D-efficiency criteria was used to estimate interactions among attributes. Multinomial logistic regression will be used for the primary DCE analysis and to control for sociodemographic and clinical characteristics.Ethics and disseminationThe Barwon Health Human Research Ethics Committee approved the study. Findings from the study will be presented in national/international conferences and peer-reviewed journals. Our results will form the basis of a feasibility study to inform the development of a larger scale study into preferences of patients with cancer and their association with cancer outcomes.

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 Analyzing preferences for family doctor contract services in rural China: a study using discrete choice experiment

2019 ◽  
Author(s):  
peipei Fu ◽  
Yi Wang ◽  
Shimeng Liu ◽  
Jiajia Li ◽  
qiufeng Gao ◽  
...  
Keyword(s):  
Educational Attainment ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Family Doctor ◽  
Preference Heterogeneity ◽  
Reimbursement Rate ◽  
Rural Residents ◽  
The Family ◽  
Good Attitude

Abstract Background: Preliminary evaluations have found that family doctor contract service has significantly controlled medical expenses, better managed chronic diseases, and increased patient satisfaction and service compliance. In 2016, China proposed the establishment of a family doctor system to carry out contract services, but studies have found uptake and utilization of these services to be limited. This study aimed to investigate rural resident preferences for FDCS from the public perspective in China. Methods : A discrete choice experiment (DCE) was performed to elicit respondent preferences towards FDCS among rural residents in China. Attributes and levels were established based on literature review and qualitative methods. Five attributes consisted of cost, medicine availability, reimbursement rate, competence of the family doctor, and attitude of the family doctor were evaluated using mixed logit model. Results: A total number of 609 residents were included in the main DCE analysis. Respondents valued high competence (coefficient 2.44, [SE 0.13]) and good attitude (coefficient 1.42, [SE 0.09]) of the family doctor most. Cost was negatively valued (coefficient -0.01, [SE 0.01]) as expected. The preference heterogeneity analysis was conducted after adjusting the interaction terms, we found that rural residents with lower educational attainment prefer good attitude than those with higher educational attainment counterparts. The estimated willingness to pay (WTP) for “high” relative to “low” competence was 441.13 RMB/year and WTP for a provider with a “good” relative to a “poor” attitude was 255.77 RMB/year. Conclusion: This present study suggested priorities should be given to strengthen and improve the quality of primary health care including family doctors’ competence and attitudes so as to increase the uptake of signing FDCS. The contract service package including annual cost, insurance reimbursement rate and individualized services should be redesigned and become congruent with residents with different health status and their stated preferences.

Sign in / Sign up

Export Citation Format

Share Document