scholarly journals Employment preferences of obstetricians and gynecologists to work in the district hospitals: evidence from a discrete choice experiment in Nepal

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Bishnu Gautam ◽  
Vishnu Prasad Sapkota ◽  
Rajendra Raj Wagle
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Health Workers ◽  
Fractional Factorial ◽  
Model Parameters ◽  
Job Attributes ◽  
Recruitment And Retention ◽  
District Hospitals ◽  
Choice Sets

Abstract Background A mismatch between the requirement and annual production of obstetricians and gynecologists (OBs-GYNs) was observed in Nepal. On top of that, recruitment and retention of OBs-GYNs is a pressing problem, especially in district hospitals of Nepal. In this connection, evidence on the job priorities and preferences of OBs-GYNs, which is currently lacking in Nepal, would help in policymakers in devising recruitment and retention strategies in these hospitals. This study, therefore, aims at exploring the most relevant job attributes that OBs-GYNs would prefer to work in the district hospitals of Nepal using a discrete choice experiment (DCE) technique. Methods Job attributes relevant to design the questionnaire were identified using keyinformant interviews and focusgroup discussions with policymakers and top managers. Then, 48 choice sets were developed using a fractional factorial design. Using these unlabeled choice sets, a DCE was conducted among 189 OBs-GYNs. The multinomial logistic regression model was used to estimate the marginal utilities and other model parameters. The willingness to pay/accept estimates was also measured for each job attribute. Results OBs-GYNs preferred the presence of a full team at the workplace (OB-GYN, pediatrician, and anesthesiologist), provision of primary and secondary education for children, and opportunity of private practice. On the other hand, a few job attributes such as a higher duration of service in district hospitalsand the provisions of a car allowance were preferred less by the respondents. Results from the marginal utility by the OBs-GYNs would be open to trade among the attributes. Conclusions The job attributes identified as incentives in this study should be included in a package to attract OBs-GYNs to serve in district hospitals of Nepal rather than offering a standard incentive package to all health workers. Similarly, this study confirmed the importance of the combination of non-monetary and monetary interventions in attracting and retaining health workers in district hospitals of Nepal.

scholarly journals Penentuan Kriteria Pengunjung dalam Pemilihan Green Hotel di Kota Bandung Menggunakan Metode Discrete Choice Experiment dengan Desain Choice Sets Kombinatorial

2021 ◽  
Vol 1 (1) ◽  
pp. 1-9
Author(s):  
Sheila Ghazia Shofwani ◽  
Abdul Kudus
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Green Building ◽  
Preference Assessment ◽  
The United States ◽  
Fractional Factorial ◽  
Discrete Choice Experiments ◽  
Green Hotel ◽  
Choice Sets

Abstract. This research discusses about planning of guest formulation in the selection of environmentally green hotels by using a 2k-p factorial fractional design and combinatorial choice sets on the Discrete Choice Experiment method. Discrete Choice Experiments is a quantitative method for survey-based respondents' preference assessment. This method asks respondents to choose the preferred choice from several alternative choices provided. With this method the authors will apply to the case of green hotel selection, because currently in the United States, investors are beginning to look at green building opportunities as a long-term investment in accordance with the operational costs of green buildings that are more efficient than conventional buildings. The concept of green building is one of the efforts to save energy that can be applied to a building. The material of this study is primary data by distributing questionnaires to respondents using voluntary sampling techniques. In this study, there are 8 independent variables consisting of 5 attribute variables and 3 respondent identity variables. This study aims to determine the criteria for visitors in choosing the most desirable green hotel. The results of this study are the results of green hotel research that is most sought after by visitors, namely hotels with quality luxury rooms, toiletries provided, visitors are required to improve the environment, there is the practice of using plastic on product packaging, and there is the use of lamps as well as energy-saving equipment. After further analysis of the demographics of respondents regarding the preference of the selected green hotel criteria for each respondent, and the results obtained at the time, gender, occupation and experience of staying in a green hotel together are not related to the involvement of the selected green hotel criteria chosen from each respondent. Abstrak. Skripsi ini membahas mengenai penentuan rancangan kriteria pengunjung dalam pemilihan hotel ramah lingkungan (green hotel) dengan menggunakan desain fractional factorial 2k-p dan choice sets kombinatorial pada metode Discrete Choice Experiment. Discrete Choice Experiment merupakan metode kuantitatif untuk menilai suatu preferensi seorang responden yang berbasis survei. Metode ini meminta responden untuk memilih pilihan yang diminati dari beberapa alternatif pilihan yang disediakan. Dengan metode ini penulis akan melakukan penerapan pada kasus pemilihan kriteria green hotel, karena saat ini di Amerika Serikat, para investor mulai melirik peluang green building sebagai investasi jangka panjang dikarenakan biaya operasional green building yang lebih hemat dibandingkan bangunan konvensional. Konsep green building merupakan salah satu upaya penghematan energi yang dapat diterapkan pada suatu gedung. Bahan dari penelitian ini merupakan data primer dengan melakukan penyebaran kuesioner kepada responden dengan menggunakan teknik sampling sukarela. Pada penelitian ini, terdapat 8 variabel independen yang terdiri dari 5 variabel atribut dan  3 variabel identitas responden. Penelitian ini bertujuan untuk mengetahui kriteria pengunjung dalam memilih green hotel yang paling diminati. Hasil dari penelitian ini adalah didapatkan kriteria green hotel yang paling diminati oleh pengunjung yaitu hotel dengan kualitas kamar mewah, perlengkapan mandi disediakan, pengunjung diwajibkan untuk menjaga lingkungan, ada praktik penggunaan plastik pada kemasan produk, dan ada penggunaan lampu juga peralatan hemat energi. Setelah itu dilakukan analisis lanjutan mengenai pengaruh dari demografi responden terhadap banyaknya keterpilihan kriteria green hotel terpilih pada setiap responden, dan diperoleh hasil bahwa usia, jenis kelamin, pekerjaan dan pengalaman menginap di green hotel secara bersama-sama tidak berpengaruh terhadap banyaknya keterpilihan kriteria green hotel terpilih dari setiap responden.

scholarly journals Analysis of policy interventions to attract and retain nurse midwives in rural areas of Malawi: A discrete choice experiment

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253518
Author(s):  
Leslie Berman ◽  
Levison Nkhoma ◽  
Margaret Prust ◽  
Courtney McKay ◽  
Mihereteab Teshome ◽  
...  
Keyword(s):  
Health Worker ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Rural Areas ◽  
Choice Experiment ◽  
Health Workers ◽  
Scale Up ◽  
Unequal Distribution ◽  
Recruitment And Retention ◽  
Facility Level

Background Inadequate and unequal distribution of health workers are significant barriers to provision of health services in Malawi, and challenges retaining health workers in rural areas have limited scale-up initiatives. This study therefore aims to estimate cost-effectiveness of monetary and non-monetary strategies in attracting and retaining nurse midwife technicians (NMTs) to rural areas of Malawi. Methods The study uses a discrete choice experiment (DCE) methodology to investigate importance of job characteristics, probability of uptake, and intervention costs. Interviews and focus groups were conducted with NMTs and students to identify recruitment and retention motivating factors. Through policymaker consultations, qualitative findings were used to identify job attributes for the DCE questionnaire, administered to 472 respondents. A conditional logit regression model was developed to produce probability of choosing a job with different attributes and an uptake rate was calculated to estimate the percentage of health workers that would prefer jobs with specific intervention packages. Attributes were costed per health worker year. Results Qualitative results highlighted housing, facility quality, management, and workload as important factors in job selection. Respondents were 2.04 times as likely to choose a rural job if superior housing was provided compared to no housing (CI 1.71–2.44, p<0.01), and 1.70 times as likely to choose a rural job with advanced facility quality (CI 1.47–1.96, p<0.01). At base level 43.9% of respondents would choose a rural job. This increased to 61.5% if superior housing was provided, and 72.5% if all facility-level improvements were provided, compared to an urban job without these improvements. Facility-level interventions had the lowest cost per health worker year. Conclusions Our results indicate housing and facility-level improvements have the greatest impact on rural job choice, while also creating longer-term improvements to health workers’ living and working environments. These results provide practical evidence for policymakers to support development of workforce recruitment and retention strategies.

scholarly journals Evaluation of Job Preference of Prospective Dentists using Discrete Choice Experiment

2017 ◽  
pp. 100-119
Author(s):  
Rabindra Man Shrestha ◽  
Sujita Shrestha ◽  
Vishnu Prasad Sapkota
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Educational Opportunity ◽  
Job Characteristics ◽  
Dental Students ◽  
Further Education ◽  
Fractional Factorial ◽  
Choice Sets ◽  
Dental Professionals

Introduction: The number of dentists is increasing in Nepal and they have a tendency to accumulate in the capital and major cities of the country. Moreover, their job priorities and professional inclinations have not been identified yet. The need, demand and supply of the dental professionals and their retention in rural areas are required to be studied from the health economics perspective. The main objective of the study was to identify preferences on job characteristics of prospective dentists and determine monetary valuation of the attributes of job choices.Methodology: Discrete choice experiment (DCE) with choice sets in the form of self-administered questionnaire was used. 402 Nepalese dental students, interns and recently graduated dentists from various universities were studied. Seven job characteristics and their corresponding levels were determined from focus group discussion. We adopted main effect fractional factorial design to create 48 choice sets. The respondents were divided into 6 blocks, with each block comprising of 8 choice sets. Each choice set comprised of two choices and an alternative specific constant (ASC). Multiple logistic regression with mixed logit model was applied to analyze the preferences of various job characteristics.Results: The response rate was 74%. Further educational opportunity was the most important job attribute for dentists in choosing their job. The order of preference for other job characteristics was: amenities at workplace, distance to workplace, private practice opportunity, and additional incentive. (p<0.01). Whereas, the job attribute CPD opportunity was not found statistically significant and has negative estimated coefficient. The ‘willingness-to-accept’ was found maximum (NRs. 144,000) for educational opportunity. (p/a). The preferences varied with gender, location and respondent category.Conclusion: Job characteristics like further education opportunity and amenities at workplace should be given importance in creating job opportunities for dentists. The offering of preferred job attributes could be helpful in retaining the dental professionals in rural areas.Economic Journal of Development Issues Vol. 19 & 20 No. 1-2 (2015) Combined Issue, Page: 100-119

scholarly journals Job preferences of medical and nursing students seeking employment in rural China: a discrete choice experiment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meiling Bao ◽  
Cunrui Huang
Keyword(s):  
Nursing Students ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Rural Areas ◽  
Choice Experiment ◽  
Health Workers ◽  
Rural China ◽  
Mixed Logit ◽  
Fractional Factorial ◽  
Guizhou Province

Abstract Background China has a shortage of health workers in rural areas, but little research exists on policies that attract qualified medical and nursing students to rural locations. We conducted a discrete choice experiment to determine how specific incentives would be valued by final–year students in a medical university in Guizhou Province, China. Methods Attributes of potential jobs were developed through the literature review, semi–structured interviews, and a pilot survey. Forty choice sets were developed using a fractional factorial design. A mixed logit model was used to estimate the relative strength of the attributes. Willingness to pay and uptake rates for a defined job were also calculated based on the mixed logit estimates. Results The final sample comprised 787 medical and nursing students. The statistically significant results indicated “Bianzhi” (the number of personnel allocated to each employer by the government) and physical conflicts between doctors and patients were two of the most important non-monetary job characteristics that incentivized both medical and nursing students. Policy simulation suggested that respondents were most sensitive to a salary increase, and the effect of incentive packages was stronger for students with a rural family background. Conclusions Strategies for patient–doctor relationships, Bianzhi and salary should be considered to attract final–year medical and nursing students to work in rural China. In addition, specific recruitment policy designs tailored for students with different majors and backgrounds should be taken into account.

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 Health Workers’ Job Preferences to Improve Rural Retention in Timor-Leste: Findings from a Discrete Choice Experiment

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0165940 ◽  
Author(s):  
Marc-Francois Smitz ◽  
Sophie Witter ◽  
Christophe Lemiere ◽  
Patrick Hoang-Vu Eozenou ◽  
Tomas Lievens ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Health Workers ◽  
Job Preferences ◽  
Timor Leste ◽  
Rural Retention

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 What do community health workers want? Findings of a discrete choice experiment among Accredited Social Health Activists (ASHAs) in India

2019 ◽  
Vol 4 (3) ◽  
pp. e001509 ◽  
Author(s):  
Marwa Abdel-All ◽  
Blake Angell ◽  
Stephen Jan ◽  
Martin Howell ◽  
Kirsten Howard ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class ◽  
Health Workers ◽  
Family Health ◽  
Health Check ◽  
Social Health ◽  
Significant Heterogeneity ◽  
Group 3

IntroductionA number of factors contribute to the performance and motivation of India’s Accredited Social Health Activists (ASHAs). This study aims to identify the key motivational factors (and their relative importance) that may help retain ASHAs in service.MethodsA discrete choice experiment (DCE) survey presented ASHAs with eight unlabelled choice sets, each describing two hypothetical jobs that varied based on five attributes, specifically salary, workload, travel allowance, supervision and other job benefits. Multinomial logit and latent class (LC) models were used to estimate stated preferences for the attributes.ResultWe invited 318 ASHAs from 53 primary health centres of Guntur, a district in south India. The DCE was completed by 299 ASHAs using Android tablets. ASHAs were found to exhibit a strong preference for jobs that incorporated training leading to promotion, a fixed salary and free family healthcare. ASHAs were willing to sacrifice 2530 Indian rupee (INR) from their monthly salary, for a job offering training leading to promotion opportunity and 879 INR for a free family health-check. However, there was significant heterogeneity in preferences across the respondents. The LC model identified three distinct groups (comprising 51%, 35% and 13% of our cohort, respectively). Group 1 and 2 preferences were dominated by the training and salary attributes with group 2 having higher preference for free family health-check while group 3 preferences were dominated by workload. Relative to group 3, ASHAs in groups 1 and 2 were more likely to have a higher level of education and less likely to be the main income earners for their families.ConclusionASHAs are motivated by both non-financial and financial factors and there is significant heterogeneity between workers. Policy decisions aimed at overcoming workforce attrition should target those areas that are most valued by ASHAs to maximise the value of investments into these workers.Trial registration numberCTRI/2018/03/012425.

scholarly journals Evaluation of strategies to communicate harmful and potentially harmful constituent (HPHC) information through cigarette package inserts: a discrete choice experiment

2017 ◽  
Vol 27 (6) ◽  
pp. 677-683 ◽  
Author(s):  
Ramzi G Salloum ◽  
Jordan J Louviere ◽  
Kayla R Getz ◽  
Farahnaz Islam ◽  
Dien Anshari ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Consumer Panel ◽  
Effective Manner ◽  
The Us ◽  
Choice Sets ◽  
Attribute Levels ◽  
Online Consumer ◽  
Cigarette Package

BackgroundThe US Food and Drug Administration (FDA) has regulatory authority to use inserts to communicate with consumers about harmful and potentially harmful constituents (HPHCs) in tobacco products; however, little is known about the most effective manner for presenting HPHC information.MethodsIn a discrete choice experiment, participants evaluated eight choice sets, each of which showed two cigarette packages from four different brands and tar levels (high vs low), accompanied by an insert that included between-subject manipulations (ie, listing of HPHCs vs grouping by disease outcome and numeric values ascribed to HPHCs vs no numbers) and within-subject manipulations (ie, 1 of 4 warning topics; statement linking an HPHC with disease vs statement with no HPHC link). For each choice set, participants were asked: (1) which package is more harmful and (2) which motivates them to not smoke; each with a ’no difference' option. Alternative-specific logit models regressed choice on attribute levels.Results1212 participants were recruited from an online consumer panel (725 18–29-year-old smokers and susceptible non-smokers and 487 30–64-year-old smokers). Participants were more likely to endorse high-tar products as more harmful than low-tar products, with a greater effect when numeric HPHC information was present. Compared with a simple warning statement, the statement linking HPHCs with disease encouraged quit motivation.ConclusionsNumeric HPHC information on inserts appears to produce misunderstandings that some cigarettes are less harmful than others. Furthermore, brief narratives that link HPHCs to smoking-related disease may promote cessation versus communications that do not explicitly link HPHCs to disease.

Understanding preferences for lifestyle-focused visual text messages in patients with cardiovascular and chronic respiratory disease: a discrete choice experiment (Preprint)

2020 ◽  
Author(s):  
Michael Choi ◽  
Rebecca Raeside ◽  
Karice Hyun ◽  
Stephanie Ruth Partridge ◽  
Aravinda Thiagalingam ◽  
...  
Keyword(s):  
Physical Activity ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Pulmonary Rehabilitation ◽  
Choice Experiment ◽  
Text Messaging ◽  
Text Messages ◽  
Choice Sets ◽  
Visual Text

BACKGROUND Supporting healthy lifestyle change is a key aim of cardiovascular and pulmonary rehabilitation programs. Text messaging programs have demonstrated effectiveness in cardiovascular disease risk reduction, weight loss, increasing physical activity and smoking cessation. Optimisation of text message programs may deliver greater population benefits as mobile phone usage becomes ubiquitous. Visual messaging (i.e. image-based messages) has the potential to communicate health messages via digital technology with enhanced engagement. OBJECTIVE To determine and understand patient preferences for lifestyle-focused visual text messages that support cardiovascular and pulmonary rehabilitation METHODS A discrete choice experiment was conducted in a four-stage iterative process to elicit patient preferences for features of visual messages. Attribute and level development yielded three attributes: purpose, image type and web address and 16 choice sets were subsequently constructed according to a full factorial design. Patients participating in cardiovascular and pulmonary rehabilitation were surveyed (online) for their preferences regarding the visual message choice sets. Respondents were asked to choose between 16 pairs of visual messages regarding key lifestyle behaviours, namely, physical activity and nutrition. Data were analysed by using a conditional logit model. RESULTS There was a total of 1728 observations from 54 unique respondents. Two factors that were associated with the patient preference were gain-framed purpose compared to no purpose (OR 1.93, 95% CI 1.40 – 2.65) and real images compared to cartoon images (OR 1.26, 95% CI 1.04 – 1.54). A loss-framed purpose was less preferred than no purpose (OR 0.55, 95% CI 0.42 - 0.74). Overall, patients preferred positive images that were colourful and engaging with text that supported the image with a preference for images of real people rather than cartoons. CONCLUSIONS A discrete choice experiment is a scientific method to elicit patient preferences for a visual messaging intervention designed to support change to lifestyle behaviours. Text messaging programs which utilise visual aids may find greater patient satisfaction by employing a gain-frame, using real images and avoiding a loss-frame. Further research is needed to explore feasibility of implementation and health and behavioural outcomes associated with such visual messaging programs.

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