The introduction of integrated out-of-hours arrangements in England: a discrete choice experiment of public preferences for alternative models of care

Gerard, Karen, Lattimer, Val, Surridge, Heidi, George, Steve, Turnbull, Joanne, Burgess, Abigail, Lathlean, Judith and Smith, Helen (2006) The introduction of integrated out-of-hours arrangements in England: a discrete choice experiment of public preferences for alternative models of care. Health Expectations, 9, (1), 60-69. (doi:10.1111/j.1369-7625.2006.00365.x).


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Objective: To establish which generic attributes of general practice out-of-hours health services are important to the public.

Methods: A discrete choice experiment postal survey conducted in three English general practitioner (GP) co-operatives. A total of 871 individuals aged 20–70?years registered with a GP. Outcomes were preferences for, and trade-offs between: time to making initial contact, time waiting for advice/treatment, informed of expected waiting time, type of contact, professional providing advice, chance contact relieves anxiety, and utility estimates for valuing current models of care.

Results: Response rate was 37%. Respondents valued out-of-hours contact for services for reducing anxiety but this was not the only attribute of importance. They had preferences for the way in which services were organized and valued information about expected waiting time, supporting findings from elsewhere. Participants were most willing to make trade-offs between waiting time and professional person. Of the predicted utility for three models of care utility was higher for fully integrated call management.

Conclusions: Greater utility might be achieved if existing services are re-configured more in line with the government's fully integrated call management model. Because the attributes were described in generic terms, the findings can be applied more generally to the plethora of models that exist (and many that might exist in the future). The approach used is important for achieving greater public involvement in how health services develop. Few experiments have elicited public preferences for health services in the UK to date. This study showed valid preferences were expressed but there were problems obtaining representative views from the public.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1111/j.1369-7625.2006.00365.x
ISSNs: 1369-6513 (print)
1369-7625 (electronic)
Related URLs:
Keywords: integrated out-of-hours, discrete choice experiment, public preference, models of care, health economics,
Subjects: R Medicine > RA Public aspects of medicine
Divisions : University Structure - Pre August 2011 > Superseded (SONM) > Superseded (HSR)
University Structure - Pre August 2011 > School of Medicine > Community Clinical Sciences
ePrint ID: 19224
Accepted Date and Publication Date:
March 2006Published
Date Deposited: 07 Feb 2006
Last Modified: 31 Mar 2016 11:36

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