L13

Question 1

Why are DCEs used?

Answer 1

Is often difficult to attach a monetary value to a HC benefit - eg. how much is a kidney worth???

Question 2

2 approaches to benefit valuation?

Answer 2

revealed preferences (value is revealed by observing the spending they do (ie. inference rather than asking)) and stated preferences (see last lecture)

Question 3

What is the theoretical basis for DCEs?

Answer 3

People derive utility from underlying attributes of a good or service therefore to understand the value of a G/S we must look at the value of these different attributes

Question 4

Explain why DCEs are not perfect?

Answer 4

Some randomness to choices such as tastes/measurement error

Question 5

DCE equation for total utility?

Answer 5

TU = systematic (explained) amount + random (unexplained) component

Question 6

What is the systematic component?

Answer 6

The explained utility derived from different attributes of a product

Question 7

What, in words, was Lancaster’s theory?

Answer 7

That could model utility for a good, k, with a regression eqn. with each attribute X, betas telling its relative explanatory power and error for random component of choices

Question 8

2 ways DCEs might be used in health econ?

Answer 8

1) HC preferences (eg. on childbirth services)

2) HC outcomes and preferences on allocation of resources towards services and research

Question 9

7 steps for carrying out a DCE?

Answer 9

1) Specify Q of interest
2) Define attributes and levels
3) Create experimental design
4) Develop and test the questionnaire
5) Administer the questionnaire and collect answers
6) Data analysis
7) Results interpretation

Socks Don’t Create DADs Running

Question 10

3 things that should be specified when specifying Q of interest in a DCE?

Answer 10

Alternative options of interest (eg. phone vs. physical consultation)

Choice format (eg. multiple choice, yes/no)

Who will be making the choice (eg. gen public/doctors etc.)

Question 11

How should the definition of attributes be carried out? How may attributes be established?

Answer 11

Should identify IMPORTANT attributes of the good/service (eg. length of consultation, convenience level etc.)

The attributes should be meaningful and reflect differences between the good or service

(may use focus groups or literature to find these attributes)

Question 12

How would the creation of experimental design be theoretically vs in practice?

Answer 12

Theoretically, would have all possible combos of levels and attributes but this can result in hundreds of Qs

Practically, use a FRACTIONAL FACTORAL design and infer an estimation of values of different characteristics of a G/S (is much more convenient)

Question 13

Additional considerations that may be made in the developing and testing phase of a DCE?

Answer 13

Opt-out scenario
Number of questions asked to each person
‘warm-up- Qs

Question 14

Main step in develop and testing phase of DCE?

Answer 14

Pilot the questionnaire to check burden and understanding

Question 15

How might questionnaires vary in their administration?

Answer 15

eg. online/face-to-face

Question 16

Problem with online surveys?

Answer 16

Often observe laziness tf inaccurate answers

Question 17

What is the data analysis stage?

Answer 17

Regression analysis, model depends on Qs being asked (eg. binary variables)

Question 18

What can the results in the final stage of a DCE be used for? (3)

Answer 18

Design new services
Predict Demand of existing services
Estimate the value placed on a service’s attribute

Question 19

What 5 attributes did Bessen et al. (2014) include in their study which looked at ‘what are the preferences of breast cancer survivors for modes of delivery of follow up services?’?

Answer 19

1) Provider (GP/nurse etc.)
2) Frequency (6mnths, 9 or yrly)
3) Location (hospital, GP, breast cancer clinic etc.)
4) Method of delivery (F2F, telephone etc.)
5) Attributes of drop-in clinic (eg. secondary prevention, psychological support, side-effects treatment)

Question 20

Explain how Bessen et al.’s survey worked?

Answer 20

254 possible choices broken down into 18 binary (A/B) choice sets split into 3 blocks of 6 questions

tf each person asked to choose between 6 pairs of programmes that varied in the 5 attributes!

Question 21

What did Bessen et al.’s results show? (3)

Answer 21

Strong preference for:

1) Breast cancer physician
2) Breast cancer follow up clinic, either F2F or both
3) Slight preference for 6mnth regularity