Informing Decision Makers About Public Preferences for Different Modalities of Cancer Treatment in the Rhône-Alps Region in France

Overview

Journal Int J Technol Assess Health Care

Publisher Cambridge University Press

Specialties Biotechnology
Health Services

Date 2023 Jan 16

PMID 36644918

Authors

Jennifer Margier

Amiram Gafni

Nora Moumjid

Affiliations

Soon will be listed here.

Abstract

Background: Alternative options to hospital care like home care or local health centers (LHCs) are being advocated. However, no study has measured citizens' preferences (who will finance these services via taxation) for these options.

Objectives: We measured (i) citizens' preferences for these services, that is, respondents stated where they would like to get the treatment; (ii) the strength of their preference.

Methods: A computerized survey composed of (i) a decision aid to inform respondents about the three options; (ii) three scenarios, from light-to-heavy care, that respondents should rank from the most to the least preferred option of care. (iii) a contingent valuation survey (CVS) to assess how much respondents were willing to pay for their preferred option (except for hospital care if chosen, because it is the default option and free). (iv) a socio-demographic questionnaire.

Results: Data were collected from a representative sample of citizens living in the Rhône-Alps Region ( = 800). The heavier the care was, the more respondents preferred hospital care. Willingness to pay for additional taxation per household/month varied from €13.9 for light care in LHC to €19.1 for heavy home care. The small number of protesting respondents and outliers, and the close correlation between preferences, income, and WTP supports the validity of the CVS.

Conclusion: In France, for cancer, not all citizens would prefer to be treated at home rather than in a hospital. Only less than a quarter would prefer LHC. These results show the mismatch between public health policies and the citizens' preferences.

References

Margier J, Gafni A, Moumjid N . Cancer care at home or in local health centres versus in hospital: Public policy goals and patients' preferences in the Rhône-Alps region in France. Health Policy. 2020; 125(2):213-220. DOI: 10.1016/j.healthpol.2020.11.011. View

Baker R, Currie G, Donaldson C . What needs to be done in contingent valuation: have Smith and Sach missed the boat?. Health Econ Policy Law. 2010; 5(Pt 1):113-21. DOI: 10.1017/s174413310999003x. View

Shepperd S, Goncalves-Bradley D, Straus S, Wee B . Hospital at home: home-based end-of-life care. Cochrane Database Syst Rev. 2016; 2:CD009231. PMC: 7111432. DOI: 10.1002/14651858.CD009231.pub2. View

Smith R, Sach T . Contingent valuation: (still) on the road to nowhere?. Health Econ. 2009; 18(8):863-6. DOI: 10.1002/hec.1527. View

Elwyn G, OConnor A, Stacey D, Volk R, Edwards A, Coulter A . Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ. 2006; 333(7565):417. PMC: 1553508. DOI: 10.1136/bmj.38926.629329.AE. View

Leff B, Burton L, Mader S, Naughton B, Burl J, Clark R . Satisfaction with hospital at home care. J Am Geriatr Soc. 2006; 54(9):1355-63. DOI: 10.1111/j.1532-5415.2006.00855.x. View

Luthi F, Fucina N, Divorne N, Santos-Eggimann B, Currat-Zweifel C, Rollier P . Home care--a safe and attractive alternative to inpatient administration of intensive chemotherapies. Support Care Cancer. 2011; 20(3):575-81. DOI: 10.1007/s00520-011-1125-9. View

Chapman G . Your money or your health: time preferences and trading money for health. Med Decis Making. 2002; 22(5):410-6. DOI: 10.1177/027298902236929. View

Sever I, Verbic M, Sever E . Estimating willingness-to-pay for health care: A discrete choice experiment accounting for non-attendance to the cost attribute. J Eval Clin Pract. 2019; 25(5):843-849. DOI: 10.1111/jep.13095. View

10.

Gyrd-Hansen D, Jensen M, Kjaer T . Framing the willingness-to-pay question: impact on response patterns and mean willingness to pay. Health Econ. 2013; 23(5):550-63. DOI: 10.1002/hec.2932. View

11.

Ryan M, Watson V . Comparing welfare estimates from payment card contingent valuation and discrete choice experiments. Health Econ. 2008; 18(4):389-401. DOI: 10.1002/hec.1364. View

12.

Donaldson C . Eliciting patients' values by use of 'willingness to pay': letting the theory drive the method. Health Expect. 2001; 4(3):180-8. PMC: 5060062. DOI: 10.1046/j.1369-6513.2001.00126.x. View

13.

Syrowatka A, Kromker D, Meguerditchian A, Tamblyn R . Features of Computer-Based Decision Aids: Systematic Review, Thematic Synthesis, and Meta-Analyses. J Med Internet Res. 2016; 18(1):e20. PMC: 4748141. DOI: 10.2196/jmir.4982. View

14.

Smith R . Contingent valuation in health care: does it matter how the 'good' is described?. Health Econ. 2007; 17(5):607-17. DOI: 10.1002/hec.1280. View

15.

Bijlenga D, Bonsel G, Birnie E . Eliciting willingness to pay in obstetrics: comparing a direct and an indirect valuation method for complex health outcomes. Health Econ. 2010; 20(11):1392-406. DOI: 10.1002/hec.1678. View

16.

Smith R, Sach T . Contingent valuation: has the debate begun?. Health Econ Policy Law. 2010; 5(Pt 1):133-4. DOI: 10.1017/s1744133109990041. View

17.

Mahieu P, Riera P, Giergiczny M . Determinants of willingness-to-pay for water pollution abatement: a point and interval data payment card application. J Environ Manage. 2012; 108:49-53. DOI: 10.1016/j.jenvman.2012.04.036. View

18.

Smith R . It's not just what you do, it's the way that you do it: the effect of different payment card formats and survey administration on willingness to pay for health gain. Health Econ. 2005; 15(3):281-93. DOI: 10.1002/hec.1055. View

19.

Anderson K, Brackenbury L, Quackenbush M, Buras M, Brown S, Price J . A-SIDE: Video simulation of teen alcohol and marijuana use contexts. J Stud Alcohol Drugs. 2014; 75(6):953-7. PMC: 4211336. DOI: 10.15288/jsad.2014.75.953. View

20.

Smith R, Sach T . Contingent valuation: what needs to be done?. Health Econ Policy Law. 2009; 5(Pt 1):91-111. DOI: 10.1017/S1744133109990016. View