The introduction of integrated out-of-hours arrangements in England: A discrete choice experiment of public preferences for alternative models of care

Gerard, K., Lattimer, V., Surridge, H., George, S., Turnbull, J., Burgess, A., Lathlean, J. and Smith, H. (2006) The introduction of integrated out-of-hours arrangements in England: A discrete choice experiment of public preferences for alternative models of care. Health Expectations, 9 (1). pp. 60-69. ISSN 10.1111/j.1369-7625.2006.00365.x

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Abstract

Objective To establish which generic attributes of general practice out-of-hours health services are important to the public. Methods A discrete choice experiment postal survey conducted in three English general practitioner (GP) co-operatives. A total of 871 individuals aged 20–70 years registered with a GP. Outcomes were preferences for, and trade-offs between: time to making initial contact, time waiting for advice/treatment, informed of expected waiting time, type of contact, professional providing advice, chance contact relieves anxiety, and utility estimates for valuing current models of care. Results Response rate was 37%. Respondents valued out-of-hours contact for services for reducing anxiety but this was not the only attribute of importance. They had preferences for the way in which services were organized and valued information about expected waiting time, supporting findings from elsewhere. Participants were most willing to make trade-offs between waiting time and professional person. Of the predicted utility for three models of care utility was higher for fully integrated call management. Conclusions Greater utility might be achieved if existing services are re-configured more in line with the government's fully integrated call management model. Because the attributes were described in generic terms, the findings can be applied more generally to the plethora of models that exist (and many that might exist in the future). The approach used is important for achieving greater public involvement in how health services develop. Few experiments have elicited public preferences for health services in the UK to date. This study showed valid preferences were expressed but there were problems obtaining representative views from the public.

Item Type: Article
Keywords: discrete choice experiment • health economics • public preference elicitation
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Depositing User: Jane Harle
Date Deposited: 20 Oct 2008
Last Modified: 30 Nov 2012 16:53
URI: http://sro.sussex.ac.uk/id/eprint/2011
Google Scholar:8 Citations
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