Eliciting individual preferences for health care: a case study of perinatal care |
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Authors: | Marjon van der Pol PhD,Alan Shiell PhD,&dagger &Dagger ,Flora Au MA,§ ,David Jonhston MA,¶ Suzanne Tough PhD,&Dagger ¶ |
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Affiliation: | Health Economics Research Unit, University of Aberdeen, Aberdeen, UK;, Population Health Intervention Research Centre, University of Calgary;, Department of Community Health Sciences, University of Calgary;, Department of Medicine, University of Calgary;and Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada |
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Abstract: | Objective To demonstrate how a discrete choice experiment (DCE) can be used to elicit individuals' preferences for health care and how these preferences can be incorporated into a cost–benefit analysis. Methods A DCE which elicited preferences for three perinatal services: specialist nurse appointments; home visits from a trained lay visitor; and home-help. Cost was included to obtain a monetary measure of the value that individuals place on the services. In total, 292 women who had previously participated in a randomized trial of alternative forms of pre-natal care were interviewed. Results The most preferred service configuration consisted of three nurse appointments and two home visits before birth and 4 h of home-help per week for the first 4 weeks after birth. On average, women are willing to pay $371 for this package. A package that excluded home-help was valued at $122 whilst provision of three nurse appointments only was valued at $97. The predicted uptake of the services ranged from 37% to 93% depending on the woman's experience with the service, whether or not it was her first child and her level of education. Conclusion The willingness to pay values were much higher than the costs for nurse appointments, suggesting this service produces a net social benefit. The willingness to pay for the package including both the nurse appointments and home visits only just exceeded the costs of the package, suggesting there is a relatively high chance that this package produces a net social loss. |
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Keywords: | cost–benefit analysis discrete choice experiments perinatal care |
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