Discrete Choice Experiments in Health Care: theory and applications

Abstract

Health economics is concerned with issues related to scarcity in the allocation of health care. The basic tasks of any economic evaluation are to identify, measure, value, and compare the costs and benefits of alternatives being considered. Traditional means of measuring benefits in the delivery of health care have concentrated on improvements in health outcomes using clinical outcomes and Quality Adjusted Life Years (QALY). The QALY is a measure of the quantity of life gained weighted by the quality of that life. QALYs are extensively used in economic analyses in health care. They claim to capture the health outcome benefits caused by an intervention . However, benefits of a health care intervention or service can be many-sided, e.g. containing non-health outcomes (e.g. amount of information) and process characteristics (e.g. treatment location, route of drug administration, patient experienced burden of testing). For instance, is ‘reduction of dying from cervical cancer’ the only screening characteristic that is considered by women attending a cervical cancer screening programme? Evidence shows that, within the context of cervical cancer screening, women’s preferences for various programmes are also determined by other characteristics than the reduced chance of dying from cervical cancer. Individuals are willing to trade changes in health outcome (change in chance of dying from cervical cance