The University of Southampton
University of Southampton Institutional Repository

Decision-making criteria among national policymakers in five countries: a discrete choice experiment eliciting relative preferences for equity and efficiency

Decision-making criteria among national policymakers in five countries: a discrete choice experiment eliciting relative preferences for equity and efficiency
Decision-making criteria among national policymakers in five countries: a discrete choice experiment eliciting relative preferences for equity and efficiency
Worldwide, there is a need for formalization of the priority setting processes in health. Recent research has used the term multicriteria decision analysis for methods that systematically include preferences for both equity and efficiency. The present study compares decision-makers' preferences at the country level for a set of equity and efficiency criteria according to a multicriteria decision analysis framework.
METHODS:

Discrete choice experiments were conducted for Brazil, Cuba, Nepal, Norway, and Uganda. By using standardized methods, we elicited preferences for intervention attributes using a individual choice questionnaire. A multinomial logistic regression was applied to estimate the coefficients for all single-policy criteria, per country. Attributes were assigned to an equity group or to an efficiency group. After testing for scale variance, predicted probabilities for interventions with both types of attributes were compared across countries.
RESULTS:

The Norway and Nepal groups showed considerable preferences for efficiency criteria over equity criteria with percent change in respective predicted sum probabilities of [10%, -84%] and [6%, -79%]. Brazil and Uganda also showed preference for the efficiency criteria though less convincingly ([-34%, -93%], [-18%, -63%], respectively). The Cuban group showed the strongest preferences with equity attributes dominating efficiency ([-52%, 213%]).
CONCLUSIONS:

Group preferences of policymakers show explicit but varying trade-offs of efficiency and equity in these diverse settings. This multicriteria decision analysis approach, using discrete choice experiments, indicates that systematic setting of health priorities is possible across a variety of countries. It may be a valuable tool to guide health reform initiatives.
discrete choice experiment, efficiency, equity, priority setting
1098-3015
534-539
Mirelman, Andrew
3a12ce0d-03c5-4b55-a144-f430be08f9c4
Mentzakis, Emmanouil
c0922185-18c7-49c2-a659-8ee6d89b5d74
Kinter, Elizabeth
56dbe9ad-57b8-45d4-b3cc-d20b1cd27698
Paolucci, Francesco
073b630d-7adc-41ee-b198-6b33bcacce6c
Fordham, Richard
237d629e-e715-4b58-8329-1acbb08d90e7
Ozawa, Sachiko
11bcb6a1-ea61-4423-8c09-516444a07a2b
Ferraz, Marcos
989908f9-22eb-4ead-8b62-7f1550e4946c
Baltussen, Rob
8e8cdb86-76f6-4487-a7e1-d03f4b4022e5
Niessen, Louis W.
97796afc-0c4f-43e9-98f6-a6c6a78e2ab2
Mirelman, Andrew
3a12ce0d-03c5-4b55-a144-f430be08f9c4
Mentzakis, Emmanouil
c0922185-18c7-49c2-a659-8ee6d89b5d74
Kinter, Elizabeth
56dbe9ad-57b8-45d4-b3cc-d20b1cd27698
Paolucci, Francesco
073b630d-7adc-41ee-b198-6b33bcacce6c
Fordham, Richard
237d629e-e715-4b58-8329-1acbb08d90e7
Ozawa, Sachiko
11bcb6a1-ea61-4423-8c09-516444a07a2b
Ferraz, Marcos
989908f9-22eb-4ead-8b62-7f1550e4946c
Baltussen, Rob
8e8cdb86-76f6-4487-a7e1-d03f4b4022e5
Niessen, Louis W.
97796afc-0c4f-43e9-98f6-a6c6a78e2ab2

Mirelman, Andrew, Mentzakis, Emmanouil, Kinter, Elizabeth, Paolucci, Francesco, Fordham, Richard, Ozawa, Sachiko, Ferraz, Marcos, Baltussen, Rob and Niessen, Louis W. (2012) Decision-making criteria among national policymakers in five countries: a discrete choice experiment eliciting relative preferences for equity and efficiency. Value in Health, 15 (3), 534-539. (doi:10.1016/j.jval.2012.04.001). (PMID:22583464)

Record type: Article

Abstract

Worldwide, there is a need for formalization of the priority setting processes in health. Recent research has used the term multicriteria decision analysis for methods that systematically include preferences for both equity and efficiency. The present study compares decision-makers' preferences at the country level for a set of equity and efficiency criteria according to a multicriteria decision analysis framework.
METHODS:

Discrete choice experiments were conducted for Brazil, Cuba, Nepal, Norway, and Uganda. By using standardized methods, we elicited preferences for intervention attributes using a individual choice questionnaire. A multinomial logistic regression was applied to estimate the coefficients for all single-policy criteria, per country. Attributes were assigned to an equity group or to an efficiency group. After testing for scale variance, predicted probabilities for interventions with both types of attributes were compared across countries.
RESULTS:

The Norway and Nepal groups showed considerable preferences for efficiency criteria over equity criteria with percent change in respective predicted sum probabilities of [10%, -84%] and [6%, -79%]. Brazil and Uganda also showed preference for the efficiency criteria though less convincingly ([-34%, -93%], [-18%, -63%], respectively). The Cuban group showed the strongest preferences with equity attributes dominating efficiency ([-52%, 213%]).
CONCLUSIONS:

Group preferences of policymakers show explicit but varying trade-offs of efficiency and equity in these diverse settings. This multicriteria decision analysis approach, using discrete choice experiments, indicates that systematic setting of health priorities is possible across a variety of countries. It may be a valuable tool to guide health reform initiatives.

This record has no associated files available for download.

More information

Published date: May 2012
Keywords: discrete choice experiment, efficiency, equity, priority setting
Organisations: Economics

Identifiers

Local EPrints ID: 345215
URI: http://eprints.soton.ac.uk/id/eprint/345215
ISSN: 1098-3015
PURE UUID: e910daac-cea5-4ffa-9628-f27578d6d943
ORCID for Emmanouil Mentzakis: ORCID iD orcid.org/0000-0003-1761-209X

Catalogue record

Date deposited: 14 Nov 2012 11:26
Last modified: 15 Mar 2024 03:42

Export record

Altmetrics

Contributors

Author: Andrew Mirelman
Author: Elizabeth Kinter
Author: Francesco Paolucci
Author: Richard Fordham
Author: Sachiko Ozawa
Author: Marcos Ferraz
Author: Rob Baltussen
Author: Louis W. Niessen

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×