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Can healthcare choice be predicted using stated preference data?

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Discrete Choice Experiments (DCEs) accurately predict healthcare choices, including influenza vaccination uptake. Understanding preference heterogeneity and external factors improves prediction accuracy for better healthcare decision-making.

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Area of Science:

  • Health Economics
  • Behavioral Science
  • Decision Science

Background:

  • Discrete Choice Experiments (DCEs) are valuable for healthcare decision-making but lack external validity evidence.
  • Predicting real-world healthcare choices from stated preferences is crucial for policy and practice.

Purpose of the Study:

  • To examine the external validity of DCE-sourced preferences in healthcare.
  • To identify determinants of preference discordance between stated choices and actual behavior.
  • To assess the predictability of healthcare choices using DCE.

Main Methods:

  • A six-step approach including literature review, expert interviews, focus groups, a DCE survey, and field data collection.
  • Analysis of stated choices via random-utility-maximization and random-regret-minimization models.
  • In-depth interviews with discordant respondents, integrating five scientific theories to explain discrepancies.

Main Results:

  • DCE predictions accurately matched real-world influenza vaccination choices at aggregate (100%) and individual (91%) levels when accounting for scale and preference heterogeneity.
  • A 13% discordance rate was observed between stated preferences and actual healthcare utilization.
  • Factors like attitude, social support, planning, barriers, and intention explained observed discordance.

Conclusions:

  • DCEs provide accurate healthcare choice predictions when scale and preference heterogeneity are considered.
  • External factors beyond DCE attributes, such as goals and social norms, significantly influence behavior and can be addressed to improve predictive models.
  • Further research on behavioral inhibitors and constraints can enhance the predictive power of DCEs in healthcare interventions.