scholarly journals Discrete choice experiment for eliciting preference for health services for patients with ALS and their informal caregivers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katy Tobin ◽  
Sinead Maguire ◽  
Bernie Corr ◽  
Charles Normand ◽  
Orla Hardiman ◽  
...  
Keyword(s):  
Health Services ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Strong Preference ◽  
Multidisciplinary Teams ◽  
Relative Importance ◽  
Trade Offs ◽  
Als Patients ◽  
The Impact

Abstract Background Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative condition with a mean life expectancy of 3 years from first symptom. Understanding the factors that are important to both patients and their caregivers has the potential to enhance service delivery and engagement, and improve efficiency. The Discrete Choice Experiment (DCE) is a stated preferences method which asks service users to make trade-offs for various attributes of health services. This method is used to quantify preferences and shows the relative importance of the attributes in the experiment, to the service user. Methods A DCE with nine choice sets was developed to measure the preferences for health services of ALS patients and their caregivers and the relative importance of various aspects of care, such as timing of care, availability of services, and decision making. The DCE was presented to patients with ALS, and their caregivers, recruited from a national multidisciplinary clinic. A random effects probit model was applied to estimate the impact of each attribute on a participant’s choice. Results Patients demonstrated the strongest preferences about timing of receiving information about ALS. A strong preference was also placed on seeing the hospice care team later rather than early on in the illness. Patients also indicated their willingness to consider the use of communication devices. Grouping by stage of disease, patients who were in earlier stages of disease showed a strong preference for receipt of extensive information about ALS at the time of diagnosis. Caregivers showed a strong preference for engagement with healthcare professionals, an attribute that was not prioritised by patients. Conclusions The DCE method can be useful in uncovering priorities of patients and caregivers with ALS. Patients and caregivers have different priorities relating to health services and the provision of care in ALS, and patient preferences differ based on the stage and duration of their illness. Multidisciplinary teams must calibrate the delivery of care in the context of the differing expectations, needs and priorities of the patient/caregiver dyad.

scholarly journals Exploring the Factors that Influence Workforce Participation for People with Multiple Sclerosis: A Discrete Choice Experiment

2021 ◽  
Author(s):  
Elizabeth Goodwin ◽  
Annie Hawton ◽  
Jennifer A. Whitty ◽  
Colin Green
Keyword(s):  
Multiple Sclerosis ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class ◽  
Latent Class Models ◽  
Relative Importance ◽  
Workforce Participation ◽  
Job Flexibility ◽  
The Impact

AbstractPurpose Research indicates that employment is beneficial for people with multiple sclerosis (MS). However, people with MS typically face reduced workforce participation compared to the general population. Using a discrete choice experiment (DCE) we explored which factors are most important in influencing employment choices of people with MS, and whether the relative importance of factors differs between subgroups. Methods Attributes and levels for the DCE were developed using a systematic literature review and public involvement techniques with people with MS. In an online survey, respondents were asked to choose between two hypothetical job scenarios described using six attributes. We used a large, national register (the UK MS Register), to recruit participants aged 18–64 years with a diagnosis of MS. Choice data were analysed using multinomial logit and latent class models. Results Analyses were based on responses from 2350 people with MS. The preferred model specification was a latent class model, with three classes of respondent. The relative importance of attributes varied between classes, with one giving the greatest weight to the impact of work on other aspects of their lives, the second to having supportive bosses and colleagues, and the third to job flexibility. The classes differed significantly in terms of age and gender, type of MS, and socio-economic status. Conclusions Significant heterogeneity was apparent among people with MS regarding the factors that influence their employment decisions. Attributes concerning the impact of work, attitudes in the workplace and job flexibility appear more influential than those concerning physical workplace adaptations.

scholarly journals Treatment Preferences of Residents Assumed to Have Severe Chronic Diseases in China: A Discrete Choice Experiment

2020 ◽  
Vol 17 (22) ◽  
pp. 8420
Author(s):  
Yinghao Lv ◽  
Qiang Fu ◽  
Xiao Shen ◽  
Erping Jia ◽  
Xianglin Li ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Care Provider ◽  
Choice Experiment ◽  
Mixed Logit ◽  
Treatment Preferences ◽  
Relative Importance ◽  
Trade Offs ◽  
The Government

Objectives: This study aims to elicit the relative importance of treatment attributes that influence residents’ choice, assuming they are suffering severe non-communicable diseases (NCDs), to explore how they make trade-offs between these attributes and to estimate the monetary value placed on different attributes and attribute levels. Methods: A discrete choice experiment (DCE) was conducted with adults over 18 years old in China. Preferences were evaluated based on four treatment attributes: care provider, mode of service, distance to practice and cost. A mixed logit model was used to analyze the relative importance of the four attributes and to calculate the willingness to pay (WTP) for a changed attribute level. Results: A total of 93.47% (2019 of 2160) respondents completed valid questionnaires. The WTP results suggested that participants would be willing to pay CNY 822.51 (USD 124.86), CNY 470.54 (USD 71.41) and CNY 68.20 (USD 10.35) for services provided by experts, with integrated traditional Chinese medicine (TCM) and Western medicine (WM) and with a service distance <=30 min, respectively. Conclusions: The results suggested that mode of service, care provider, distance to practice and cost should be considered in priority-setting decisions. The government should strengthen the curative service capability in primary health facilities and give full play to the role of TCM in the prevention and treatment of severe chronic diseases.

scholarly journals Patient preferences for use of virtual consultations in an orthopaedic rehabilitation setting: Results from a discrete choice experiment

2021 ◽  
pp. 135581962110354
Author(s):  
Anthony W Gilbert ◽  
Emmanouil Mentzakis ◽  
Carl R May ◽  
Maria Stokes ◽  
Jeremy Jones
Keyword(s):  
Conceptual Model ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Best Practice ◽  
Time Of Day ◽  
Problem Area ◽  
Fractional Factorial ◽  
The Impact

Objective Virtual Consultations may reduce the need for face-to-face outpatient appointments, thereby potentially reducing the cost and time involved in delivering health care. This study reports a discrete choice experiment (DCE) that identifies factors that influence patient preferences for virtual consultations in an orthopaedic rehabilitation setting. Methods Previous research from the CONNECT (Care in Orthopaedics, burdeN of treatmeNt and the Effect of Communication Technology) Project and best practice guidance informed the development of our DCE. An efficient fractional factorial design with 16 choice scenarios was created that identified all main effects and partial two-way interactions. The design was divided into two blocks of eight scenarios each, to reduce the impact of cognitive fatigue. Data analysis were conducted using binary logit regression models. Results Sixty-one paired response sets (122 subjects) were available for analysis. DCE factors (whether the therapist is known to the patient, duration of appointment, time of day) and demographic factors (patient qualifications, access to equipment, difficulty with activities, multiple health issues, travel costs) were significant predictors of preference. We estimate that a patient is less than 1% likely to prefer a virtual consultation if the patient has a degree, is without access to the equipment and software to undertake a virtual consultation, does not have difficulties with day-to-day activities, is undergoing rehabilitation for one problem area, has to pay less than £5 to travel, is having a consultation with a therapist not known to them, in 1 weeks’ time, lasting 60 minutes, at 2 pm. We have developed a simple conceptual model to explain how these factors interact to inform preference, including patients’ access to resources, context for the consultation and the requirements of the consultation. Conclusions This conceptual model provides the framework to focus attention towards factors that might influence patient preference for virtual consultations. Our model can inform the development of future technologies, trials, and qualitative work to further explore the mechanisms that influence preference.

scholarly journals Understanding public preferences and trade-offs for government responses during a pandemic: a protocol for a discrete choice experiment in the UK

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e043477
Author(s):  
Mesfin G Genie ◽  
Luis Enrique Loría-Rebolledo ◽  
Shantini Paranjothy ◽  
Daniel Powell ◽  
Mandy Ryan ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Online Survey ◽  
Research Unit ◽  
Media Analysis ◽  
Moral Foundation ◽  
Trade Offs ◽  
Ethics Research ◽  
The Uk

IntroductionSocial distancing and lockdown measures are among the main government responses to the COVID-19 pandemic. These measures aim to limit the COVID-19 infection rate and reduce the mortality rate of COVID-19. Given we are likely to see local lockdowns until a treatment or vaccine for COVID-19 is available, and their effectiveness depends on public acceptability, it is important to understand public preference for government responses.Methods and analysisUsing a discrete choice experiment (DCE), this study will investigate the public’s preferences for pandemic responses in the UK. Attributes (and levels) are based on: (1) lockdown measures described in policy documents; (2) literature on preferences for lockdown measures and (3) a social media analysis. Attributes include: lockdown type; lockdown length; postponement of usual non-urgent medical care; number of excess deaths; number of infections; impact on household spending and job losses. We will prepilot the DCE using virtual think aloud interviews with respondents recruited via Facebook. We will collect preference data using an online survey of 4000 individuals from across the four UK countries (1000 per country). We will estimate the relative importance of the attributes, and the trade-offs individuals are willing to make between attributes. We will test if respondents’ preferences differ based on moral attitudes (using the Moral Foundation Questionnaire), socioeconomic circumstances (age, education, economic insecurity, health status), country of residence and experience of COVID-19.Ethics and disseminationThe University of Aberdeen’s College Ethics Research Board (CERB) has approved the study (reference: CERB/2020/6/1974). We will seek CERB approval for major changes from the developmental and pilot work. Peer-reviewed papers will be submitted, and results will be presented at public health and health economic conferences nationally and internationally. A lay summary will be published on the Health Economics Research Unit blog.

scholarly journals Assessing cigarette packaging and labelling policy effects on early adolescents: results from a discrete choice experiment

2020 ◽  
pp. tobaccocontrol-2019-055463
Author(s):  
Inti Barrientos-Gutierrez ◽  
Farahnaz Islam ◽  
Yoo Jin Cho ◽  
Ramzi George Salloum ◽  
Jordan Louviere ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Early Adolescents ◽  
Interactive Effects ◽  
Brand Name ◽  
Warning Label ◽  
Plain Packaging ◽  
Tobacco Marketing ◽  
The Impact

IntroductionCigarette packaging is a primary channel for tobacco advertising, particularly in countries where traditional channels are restricted. The current study evaluated the independent and interactive effects of cigarette packaging and health warning label (HWL) characteristics on perceived appeal of cigarette brands for early adolescents in Mexico.MethodsA discrete choice experiment (DCE) was conducted with early adolescents, aged 12–14 years (n=4251). The DCE involved a 3×25 design with six attributes: brand (Marlboro, Pall Mall, Camel), tobacco flavour (regular, menthol), flavour capsule (none, 1 or 2 capsules), presence of descriptive terms, branding (vs plain packaging), HWL size (30%, 75%) and HWL content (emphysema vs mouth cancer). Participants viewed eight sets of three cigarette packs and selected a pack in each set that: (1) is most/least attractive, (2) they are most/least interested in trying or (3) is most/least harmful, with a no difference option.ResultsParticipants perceived packs as less attractive, less interesting to try and more harmful if they had plain packaging or had larger HWLs, with the effect being most pronounced when plain packaging is combined with larger HWLs. For attractiveness, plain packaging had the biggest influence on choice (43%), followed by HWL size (19%). Interest in trying was most influenced by brand name (34%), followed by plain packaging (29%). Perceived harm was most influenced by brand name (30%), followed by HWL size (29%).ConclusionIncreasing the size of HWLs and implementing plain packaging appear to reduce the appeal of cigarettes to early adolescents. Countries should adopt these policies to minimise the impact of tobacco marketing.

scholarly journals Understanding uptake of digital health products: Methodology tutorial for a Discrete Choice Experiment using a Bayesian efficient design (Preprint)

2021 ◽  
Author(s):  
Dorothy Szinay ◽  
Rory Cameron ◽  
Felix Naughton ◽  
Jennifer A. Whitty ◽  
Jamie Brown ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Stated Preference ◽  
Digital Health ◽  
Revealed Preferences ◽  
Quantitative Methodology ◽  
Efficient Design ◽  
Trade Offs ◽  
Health Products

UNSTRUCTURED Understanding the preferences of potential users of digital health products is beneficial for digital health policy and planning. Stated preference methods could help elicit individuals’ preferences in the absence of observational data. A discrete choice experiment (DCE) is a commonly used stated preference method; a quantitative methodology that argues that individuals make trade-offs when engaging in a decision by choosing an alternative of a product or service that offers the greatest utility, or benefit. This methodology is widely used in health economics in situations where revealed preferences are difficult to collect but is much less used in the field of digital health. This article outlines the stages involved in developing a discrete choice experiment. As a case study, it uses the application of a DCE for revealing preferences in targeting the uptake of smoking cessation apps. It describes the establishment of attributes, the construction of choice tasks of two or more alternatives, and the development of the experimental design. This tutorial offers a guide for researchers with no prior knowledge of this research technique.

scholarly journals Preferences of healthcare providers for capitation payment in Kenya: a discrete choice experiment

2020 ◽  
Vol 35 (7) ◽  
pp. 842-854
Author(s):  
Melvin Obadha ◽  
Jane Chuma ◽  
Jacob Kazungu ◽  
Gilbert Abotisem Abiiro ◽  
Matthew J Beck ◽  
...  
Keyword(s):  
Health Services ◽  
Health Facility ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class Models ◽  
Capitation Payment ◽  
Capitation Rate ◽  
Provider Payment ◽  
Senior Health

Abstract Provider payment mechanisms (PPMs) are important to the universal health coverage (UHC) agenda as they can influence healthcare provider behaviour and create incentives for health service delivery, quality and efficiency. Therefore, when designing PPMs, it is important to consider providers’ preferences for PPM characteristics. We set out to uncover senior health facility managers’ preferences for the attributes of a capitation payment mechanism in Kenya. We use a discrete choice experiment and focus on four capitation attributes, namely, payment schedule, timeliness of payments, capitation rate per individual per year and services to be paid by the capitation rate. Using a Bayesian efficient experimental design, choice data were collected from 233 senior health facility managers across 98 health facilities in seven Kenyan counties. Panel mixed multinomial logit and latent class models were used in the analysis. We found that capitation arrangements with frequent payment schedules, timelier disbursements, higher payment rates per individual per year and those that paid for a limited set of health services were preferred. The capitation rate per individual per year was the most important attribute. Respondents were willing to accept an increase in the capitation rate to compensate for bundling a broader set of health services under the capitation payment. In addition, we found preference heterogeneity across respondents and latent classes. In conclusion, these attributes can be used as potential targets for interventions aimed at configuring capitation to achieve UHC.

scholarly journals SARS-CoV-2 Testing Service Preferences of Adults in the United States: Discrete Choice Experiment (Preprint)

2020 ◽  
Author(s):  
Rebecca Zimba ◽  
Sarah Kulkarni ◽  
Amanda Berry ◽  
William You ◽  
Chloe Mirzayi ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Turnaround Time ◽  
Urgent Care ◽  
Relative Importance ◽  
Test Type ◽  
Specimen Type ◽  
Testing Uptake ◽  
Community Transmission

BACKGROUND Ascertaining preferences for SARS-CoV-2 testing and incorporating findings into the design and implementation of strategies for delivering testing services may enhance testing uptake and engagement, a prerequisite to reducing onward transmission. OBJECTIVE This study aims to determine important drivers of decisions to obtain a SARS-CoV-2 test in the context of increasing community transmission. METHODS We used a discrete choice experiment to assess preferences for SARS-CoV-2 test type, specimen type, testing venue, and results turnaround time. Participants (n=4793) from the US national longitudinal Communities, Households and SARS-CoV-2 Epidemiology (CHASING) COVID Cohort Study completed our online survey from July 30 to September 8, 2020. We estimated the relative importance of testing method attributes and part-worth utilities of attribute levels, and simulated the uptake of an optimized testing scenario relative to the current typical testing scenario of polymerase chain reaction (PCR) via nasopharyngeal swab in a provider’s office or urgent care clinic with results in &gt;5 days. RESULTS Test result turnaround time had the highest relative importance (30.4%), followed by test type (28.3%), specimen type (26.2%), and venue (15.0%). In simulations, immediate or same-day test results, both PCR and serology, or oral specimens substantially increased testing uptake over the current typical testing option. Simulated uptake of a hypothetical testing scenario of PCR and serology via a saliva sample at a pharmacy with same-day results was 97.7%, compared to 0.6% for the current typical testing scenario, with 1.8% opting for no test. CONCLUSIONS Testing strategies that offer both PCR and serology with noninvasive methods and rapid turnaround time would likely have the most uptake and engagement among residents in communities with increasing community transmission of SARS-CoV-2.

scholarly journals An assessment of students’ job preference using a discrete choice experiment: a postgraduate case study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Henry Gyarteng-Mensah ◽  
De-Graft Owusu-Manu ◽  
David Edwards ◽  
Isaac Baidoo ◽  
Hatem El-Gohary
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Negative Impact ◽  
Employment Decisions ◽  
Content Type ◽  
Postgraduate Students ◽  
Trade Offs ◽  
Job Preference

Purpose Using a discrete choice experiment (DCE), this study aims to better understand the job preference of postgraduate students studying at the Kwame Nkrumah University of Science and Technology-Institute of Distance Learning, Ghana and also rank the attributes of a job they deem important. Design/methodology/approach The research adopted a positivist epistemological design contextualised within a deductive approach and case study strategy. Primary survey data was collected from a stratified random sample of 128 postgraduate students with multi-sectorial career prospects. Sample students were subjected to a DCE in which their stated preferences were collected using closed-ended questionnaires with 28 pairs of hypothetical job profiles. Respondents’ preferences from the DCE data were then modelled using the conditional logit. Findings The research reveals that: salary in the range GHC 2,800.00 to GHC 3,400.00 ($1 = GHS 5.3); supportive management; very challenging jobs; and jobs located in the city were the top attributes that were significant and had the most impact in increasing the utility of selecting a particular job. Interestingly, jobs with no extra hours workload were not significant hence, had a negative impact upon student preferences. Originality/value This novel research is the first to use a DCE to better elicit preference and trade-offs of postgraduate students in a developing country towards varying job characteristics that have an impact on their future employment decisions. Knowledge advancements made provide invaluable insight to employers and policymakers on the key criteria that should be implemented to retain the best candidate.

Sign in / Sign up

Export Citation Format

Share Document