Decision-Making Criteria among National Policymakers in Five Countries: A Discrete Choice Experiment Eliciting Relative Preferences for Equity and Efficiency
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/34814 http://dx.doi.org/10.1016/j.jval.2012.04.001 |
Resumo: | Background: Worldwide, there is a need for formalization of the priority setting processes in health. Recent research has used the term multicriteria decision analysis for methods that systematically include preferences for both equity and efficiency. the present study compares decision-makers' preferences at the country level for a set of equity and efficiency criteria according to a multicriteria decision analysis framework. Methods: Discrete choice experiments were conducted for Brazil, Cuba, Nepal, Norway, and Uganda. By using standardized methods, we elicited preferences for intervention attributes using a individual choice questionnaire. A multinomial logistic regression was applied to estimate the coefficients for all single-policy criteria, per country. Attributes were assigned to an equity group or to an efficiency group. After testing for scale variance, predicted probabilities for interventions with both types of attributes were compared across countries. Results: the Norway and Nepal groups showed considerable prefer-ences for efficiency criteria over equity criteria with percent change in respective predicted sum probabilities of [10%, -84%] and [6%, -79%]. Brazil and Uganda also showed preference for the efficiency criteria though less convincingly ([-34%, -93%], [-18%, -63%], respectively). the Cuban group showed the strongest preferences with equity attributes dominating efficiency ([-52%, 213%]). Conclusions: Group preferences of policymakers show explicit but varying trade-offs of efficiency and equity in these diverse settings. This multicriteria decision analysis approach, using discrete choice experiments, indicates that systematic setting of health priorities is possible across a variety of countries. It may be a valuable tool to guide health reform initiatives. |
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Mirelman, AndrewMentzakis, EmmanouilKinter, ElizabethPaolucci, FrancescoFordham, RichardOzawa, SachikoFerraz, Marcos Bosi [UNIFESP]Baltussen, RobNiessen, Louis W.Johns Hopkins Bloomberg Sch Publ HlthUniv E AngliaCampbell AllianceAustralian Natl UnivUniversidade Federal de São Paulo (UNIFESP)Radboud Univ Nijmegen2016-01-24T14:27:08Z2016-01-24T14:27:08Z2012-05-01Value in Health. New York: Elsevier B.V., v. 15, n. 3, p. 534-539, 2012.1098-3015http://repositorio.unifesp.br/handle/11600/34814http://dx.doi.org/10.1016/j.jval.2012.04.001WOS000303940600017.pdf10.1016/j.jval.2012.04.001WOS:000303940600017Background: Worldwide, there is a need for formalization of the priority setting processes in health. Recent research has used the term multicriteria decision analysis for methods that systematically include preferences for both equity and efficiency. the present study compares decision-makers' preferences at the country level for a set of equity and efficiency criteria according to a multicriteria decision analysis framework. Methods: Discrete choice experiments were conducted for Brazil, Cuba, Nepal, Norway, and Uganda. By using standardized methods, we elicited preferences for intervention attributes using a individual choice questionnaire. A multinomial logistic regression was applied to estimate the coefficients for all single-policy criteria, per country. Attributes were assigned to an equity group or to an efficiency group. After testing for scale variance, predicted probabilities for interventions with both types of attributes were compared across countries. Results: the Norway and Nepal groups showed considerable prefer-ences for efficiency criteria over equity criteria with percent change in respective predicted sum probabilities of [10%, -84%] and [6%, -79%]. Brazil and Uganda also showed preference for the efficiency criteria though less convincingly ([-34%, -93%], [-18%, -63%], respectively). the Cuban group showed the strongest preferences with equity attributes dominating efficiency ([-52%, 213%]). Conclusions: Group preferences of policymakers show explicit but varying trade-offs of efficiency and equity in these diverse settings. This multicriteria decision analysis approach, using discrete choice experiments, indicates that systematic setting of health priorities is possible across a variety of countries. It may be a valuable tool to guide health reform initiatives.Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD 21205 USAUniv E Anglia, Norwich Med Sch, Norwich NR4 7TJ, Norfolk, EnglandCampbell Alliance, Boston, MA USAAustralian Natl Univ, Australian Ctr Econ Res Hlth, Canberra, ACT, AustraliaUniversidade Federal de São Paulo, São Paulo Ctr Hlth Econ, São Paulo, BrazilRadboud Univ Nijmegen, Dept Primary & Community Care, Nijmegen Med Ctr, NL-6525 ED Nijmegen, NetherlandsUniversidade Federal de São Paulo, São Paulo Ctr Hlth Econ, São Paulo, BrazilWeb of Science534-539engElsevier B.V.Value in Healthhttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policyinfo:eu-repo/semantics/openAccessdiscrete choice experimentefficiencyequitypriority settingDecision-Making Criteria among National Policymakers in Five Countries: A Discrete Choice Experiment Eliciting Relative Preferences for Equity and Efficiencyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlereponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALWOS000303940600017.pdfapplication/pdf279055${dspace.ui.url}/bitstream/11600/34814/1/WOS000303940600017.pdff992017c9d6ae4a43742024475f66620MD51open accessTEXTWOS000303940600017.pdf.txtWOS000303940600017.pdf.txtExtracted texttext/plain37704${dspace.ui.url}/bitstream/11600/34814/2/WOS000303940600017.pdf.txt7c95879b98762877d234715217c0fbbdMD52open access11600/348142022-11-03 10:40:51.184open accessoai:repositorio.unifesp.br:11600/34814Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652022-11-03T13:40:51Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Decision-Making Criteria among National Policymakers in Five Countries: A Discrete Choice Experiment Eliciting Relative Preferences for Equity and Efficiency |
title |
Decision-Making Criteria among National Policymakers in Five Countries: A Discrete Choice Experiment Eliciting Relative Preferences for Equity and Efficiency |
spellingShingle |
Decision-Making Criteria among National Policymakers in Five Countries: A Discrete Choice Experiment Eliciting Relative Preferences for Equity and Efficiency Mirelman, Andrew discrete choice experiment efficiency equity priority setting |
title_short |
Decision-Making Criteria among National Policymakers in Five Countries: A Discrete Choice Experiment Eliciting Relative Preferences for Equity and Efficiency |
title_full |
Decision-Making Criteria among National Policymakers in Five Countries: A Discrete Choice Experiment Eliciting Relative Preferences for Equity and Efficiency |
title_fullStr |
Decision-Making Criteria among National Policymakers in Five Countries: A Discrete Choice Experiment Eliciting Relative Preferences for Equity and Efficiency |
title_full_unstemmed |
Decision-Making Criteria among National Policymakers in Five Countries: A Discrete Choice Experiment Eliciting Relative Preferences for Equity and Efficiency |
title_sort |
Decision-Making Criteria among National Policymakers in Five Countries: A Discrete Choice Experiment Eliciting Relative Preferences for Equity and Efficiency |
author |
Mirelman, Andrew |
author_facet |
Mirelman, Andrew Mentzakis, Emmanouil Kinter, Elizabeth Paolucci, Francesco Fordham, Richard Ozawa, Sachiko Ferraz, Marcos Bosi [UNIFESP] Baltussen, Rob Niessen, Louis W. |
author_role |
author |
author2 |
Mentzakis, Emmanouil Kinter, Elizabeth Paolucci, Francesco Fordham, Richard Ozawa, Sachiko Ferraz, Marcos Bosi [UNIFESP] Baltussen, Rob Niessen, Louis W. |
author2_role |
author author author author author author author author |
dc.contributor.institution.none.fl_str_mv |
Johns Hopkins Bloomberg Sch Publ Hlth Univ E Anglia Campbell Alliance Australian Natl Univ Universidade Federal de São Paulo (UNIFESP) Radboud Univ Nijmegen |
dc.contributor.author.fl_str_mv |
Mirelman, Andrew Mentzakis, Emmanouil Kinter, Elizabeth Paolucci, Francesco Fordham, Richard Ozawa, Sachiko Ferraz, Marcos Bosi [UNIFESP] Baltussen, Rob Niessen, Louis W. |
dc.subject.eng.fl_str_mv |
discrete choice experiment efficiency equity priority setting |
topic |
discrete choice experiment efficiency equity priority setting |
description |
Background: Worldwide, there is a need for formalization of the priority setting processes in health. Recent research has used the term multicriteria decision analysis for methods that systematically include preferences for both equity and efficiency. the present study compares decision-makers' preferences at the country level for a set of equity and efficiency criteria according to a multicriteria decision analysis framework. Methods: Discrete choice experiments were conducted for Brazil, Cuba, Nepal, Norway, and Uganda. By using standardized methods, we elicited preferences for intervention attributes using a individual choice questionnaire. A multinomial logistic regression was applied to estimate the coefficients for all single-policy criteria, per country. Attributes were assigned to an equity group or to an efficiency group. After testing for scale variance, predicted probabilities for interventions with both types of attributes were compared across countries. Results: the Norway and Nepal groups showed considerable prefer-ences for efficiency criteria over equity criteria with percent change in respective predicted sum probabilities of [10%, -84%] and [6%, -79%]. Brazil and Uganda also showed preference for the efficiency criteria though less convincingly ([-34%, -93%], [-18%, -63%], respectively). the Cuban group showed the strongest preferences with equity attributes dominating efficiency ([-52%, 213%]). Conclusions: Group preferences of policymakers show explicit but varying trade-offs of efficiency and equity in these diverse settings. This multicriteria decision analysis approach, using discrete choice experiments, indicates that systematic setting of health priorities is possible across a variety of countries. It may be a valuable tool to guide health reform initiatives. |
publishDate |
2012 |
dc.date.issued.fl_str_mv |
2012-05-01 |
dc.date.accessioned.fl_str_mv |
2016-01-24T14:27:08Z |
dc.date.available.fl_str_mv |
2016-01-24T14:27:08Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Value in Health. New York: Elsevier B.V., v. 15, n. 3, p. 534-539, 2012. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/34814 http://dx.doi.org/10.1016/j.jval.2012.04.001 |
dc.identifier.issn.none.fl_str_mv |
1098-3015 |
dc.identifier.file.none.fl_str_mv |
WOS000303940600017.pdf |
dc.identifier.doi.none.fl_str_mv |
10.1016/j.jval.2012.04.001 |
dc.identifier.wos.none.fl_str_mv |
WOS:000303940600017 |
identifier_str_mv |
Value in Health. New York: Elsevier B.V., v. 15, n. 3, p. 534-539, 2012. 1098-3015 WOS000303940600017.pdf 10.1016/j.jval.2012.04.001 WOS:000303940600017 |
url |
http://repositorio.unifesp.br/handle/11600/34814 http://dx.doi.org/10.1016/j.jval.2012.04.001 |
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eng |
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Value in Health |
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http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy info:eu-repo/semantics/openAccess |
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http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy |
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openAccess |
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534-539 |
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Elsevier B.V. |
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Elsevier B.V. |
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