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Valuing Preferences for the Process and Outcomes of Clinical Genetics Services: A Pilot Study
Ewan Gray1, Martin Eden1, Caroline Vass1
1Manchester Centre for Health Economics, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
Background:
Understanding preferences for the process and outcomes of clinical genetics services (CGS) is a first step to developing these services appropriately.
Aim:
The aim of this study was to quantify the relative importance of attributes defining the process of service delivery and the patient outcomes of CGS.
Methods:
An online hybrid conjoint analysis discrete choice experiment (CA-DCE) was piloted in a purposive sample (n = 37) of CGS patients and non-patients to identify (i) service attributes (n = 13) perceived to facilitate informed decision making; (ii) relative preferences for six attributes (5 process, 1 outcome: ability to make an informed decision). A three-step approach was taken to link the data from the CA-DCE using hierarchical information integration and ordered logit and multinomial logit models. Marginal willingness-to-pay (WTP) values were calculated.
Results:
Services that facilitate informed decision making, with shorter waiting times and involving pre-consultation contact were preferred. Estimated WTP values were: service location (£3170; 95% CI -391 to 15,098); waiting time (-£1080; 95% CI -3659 to -603); pre-consultation contact (£7765; 95% CI 2542-33,937); improved informed decision making (£2254; 95% CI 775-9866).
Conclusion:
This study suggests that hybrid stated preference experiments offer a practical solution to understanding preferences for how CGS services are delivered.
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