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Equity and efficiency preferences of health policy makers in China - a stated preference analysis

Equity and efficiency preferences of health policy makers in China - a stated preference analysis
Equity and efficiency preferences of health policy makers in China - a stated preference analysis
Background Macroeconomic growth in China enables significant progress in health care and public health. It faces difficult choices regarding access, quality and affordability, while dealing with the increasing burden of chronic diseases. Policymakers are pressured to make complex decisions while implementing health strategies. This study shows how this process could be structured and reports the specific equity and efficiency preferences among Chinese policymakers.Methods In total, 78 regional, provincial and national level policymakers with considerable experience participated in a discrete choice experiment, weighting the relative importance of six policy attributes describing equity and efficiency. Results from a conditional logistic model are presented for the six criteria, measuring the associated weights. Observed and unobserved heterogeneities were incorporated and tested in the model. Findings are used to give an example of ranking health interventions in relation to the present disease burden in China.Results In general, respondents showed strong preference for efficiency criteria i.e. total beneficiaries and cost-effectiveness as the most important attributes in decision making over equity criteria. Hence, priority interventions would be those conditions that are most prevalent in the country and cost least per health gain.Conclusion Although efficiency criteria override equity ones, major health threats in China would be targeted. Multicriteria decision analysis makes explicit important trade-offs between efficiency and equity, leading to explicit, transparent and rational policy making
decision making, discrete choice experiment, efficiency, equity
0268-1080
1059-1066
Paolucci, Francesco
073b630d-7adc-41ee-b198-6b33bcacce6c
Mentzakis, Emmanouil
c0922185-18c7-49c2-a659-8ee6d89b5d74
Defechereux, Thierry
f228e3e6-99f7-4f1f-9c6a-0bc3b21f3dda
Niessen, Louis W.
97796afc-0c4f-43e9-98f6-a6c6a78e2ab2
Paolucci, Francesco
073b630d-7adc-41ee-b198-6b33bcacce6c
Mentzakis, Emmanouil
c0922185-18c7-49c2-a659-8ee6d89b5d74
Defechereux, Thierry
f228e3e6-99f7-4f1f-9c6a-0bc3b21f3dda
Niessen, Louis W.
97796afc-0c4f-43e9-98f6-a6c6a78e2ab2

Paolucci, Francesco, Mentzakis, Emmanouil, Defechereux, Thierry and Niessen, Louis W. (2015) Equity and efficiency preferences of health policy makers in China - a stated preference analysis. Health Policy and Planning, 30 (8), 1059-1066. (doi:10.1093/heapol/czu123).

Record type: Article

Abstract

Background Macroeconomic growth in China enables significant progress in health care and public health. It faces difficult choices regarding access, quality and affordability, while dealing with the increasing burden of chronic diseases. Policymakers are pressured to make complex decisions while implementing health strategies. This study shows how this process could be structured and reports the specific equity and efficiency preferences among Chinese policymakers.Methods In total, 78 regional, provincial and national level policymakers with considerable experience participated in a discrete choice experiment, weighting the relative importance of six policy attributes describing equity and efficiency. Results from a conditional logistic model are presented for the six criteria, measuring the associated weights. Observed and unobserved heterogeneities were incorporated and tested in the model. Findings are used to give an example of ranking health interventions in relation to the present disease burden in China.Results In general, respondents showed strong preference for efficiency criteria i.e. total beneficiaries and cost-effectiveness as the most important attributes in decision making over equity criteria. Hence, priority interventions would be those conditions that are most prevalent in the country and cost least per health gain.Conclusion Although efficiency criteria override equity ones, major health threats in China would be targeted. Multicriteria decision analysis makes explicit important trade-offs between efficiency and equity, leading to explicit, transparent and rational policy making

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More information

Published date: October 2015
Keywords: decision making, discrete choice experiment, efficiency, equity
Organisations: Economics

Identifiers

Local EPrints ID: 382646
URI: http://eprints.soton.ac.uk/id/eprint/382646
ISSN: 0268-1080
PURE UUID: 83df6ea3-5e0c-4323-8764-3471a26eb767
ORCID for Emmanouil Mentzakis: ORCID iD orcid.org/0000-0003-1761-209X

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Date deposited: 30 Oct 2015 14:59
Last modified: 15 Mar 2024 03:42

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Contributors

Author: Francesco Paolucci
Author: Thierry Defechereux
Author: Louis W. Niessen

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