Abstract
Background: To design cost-effective health services it is important to understand why people adopt particular symptom management strategies. Aim: To establish the relative importance of factors that influence decision-making when managing symptoms of differing severity, how people trade between these factors, and to estimate the monetary value placed on different management-types. Design: Discrete choice experiment. Setting: UK online research panel.
Method: Successive members of an online panel were invited to participate until 480 discrete choice experiment questionnaires were completed. Relative preferences for managing three symptom scenarios of varying severity were measured. Symptom management was described by three characteristics (management-type, availability and cost). Preferences for ways of managing symptoms were measured using conditional logit analysis.
Results: A total of 98.5% of completed questionnaires were valid (473/480 respondents). People preferred to manage minor symptoms by self-care or by visiting a pharmacy, and were willing to pay £21.58 and £19.06 respectively to do so. For managing moderately severe symptoms people preferred to consult a GP and were willing to pay £34.86 for this option. People preferred to manage potentially very severe symptoms by consulting a GP and were willing to pay £73.08 to do so. Respondents were willing to trade between management-types; options less preferred became more attractive when waiting time and cost were reduced.
Conclusion: People value self-care, supported self-care and GP consultation differently depending on type of symptom. Manipulating costs to users and waiting times for different services could allow policy makers to influence the services people choose when managing symptoms.
Method: Successive members of an online panel were invited to participate until 480 discrete choice experiment questionnaires were completed. Relative preferences for managing three symptom scenarios of varying severity were measured. Symptom management was described by three characteristics (management-type, availability and cost). Preferences for ways of managing symptoms were measured using conditional logit analysis.
Results: A total of 98.5% of completed questionnaires were valid (473/480 respondents). People preferred to manage minor symptoms by self-care or by visiting a pharmacy, and were willing to pay £21.58 and £19.06 respectively to do so. For managing moderately severe symptoms people preferred to consult a GP and were willing to pay £34.86 for this option. People preferred to manage potentially very severe symptoms by consulting a GP and were willing to pay £73.08 to do so. Respondents were willing to trade between management-types; options less preferred became more attractive when waiting time and cost were reduced.
Conclusion: People value self-care, supported self-care and GP consultation differently depending on type of symptom. Manipulating costs to users and waiting times for different services could allow policy makers to influence the services people choose when managing symptoms.
| Original language | English |
|---|---|
| Pages (from-to) | 1069-1076 |
| Number of pages | 8 |
| Journal | Value in Health |
| Volume | 15 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Dec 2012 |
Bibliographical note
AcknowledgmentsThanks go to Professor Blair Smith, Dr. Elizabeth Delaney, and all pilot volunteers for their assistance with the development of the symptom scenarios and to Sylvia Mendolia for analysis advice. We also acknowledge an anonymous referee whose comments made a useful contribution to this article.
Source of financial support: This research was funded through a fellowship awarded to Dr. Terry Porteous (MRC/ESRC Interdisciplinary Postdoctoral Fellowship, Ref: G0800069), with additional financial support from the BScMedSci programme at the University of Aberdeen. Ethics approval: Recruitment of participants was voluntary, and no NHS resources were used. Ethical approval was obtained from the College of Life Sciences and Medicine Ethics Review Board at the University of Aberdeen. All project methods complied with Research Council principles and policy. The principal investigator (TP) is guardian of all collected data.
Keywords
- primary health care
- discrete choice experiment
- symptom management
- willingness to pay
- health care costs