Abstract
This study developed Finnish preference weights for the seven-attribute Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer) and investigated survey fatigue and learning in best-worst scaling (BWS) experiments. An online survey that included a BWS experiment using the ASCOT-Carer was completed by a sample from the general population in Finland. A block of eight BWS profiles describing different states from the ASCOT-Carer were randomly assigned to each respondent, who consecutively made four choices (best, worst, second best and second worst) per profile. The analysis panel data had 32,160 choices made by 1005 respondents. A scale multinomial logit (S-MNL) model was used to estimate preference weights for 28 ASCOT-Carer attribute levels. Fatigue and learning effects were examined as scale heterogeneity. Several specifications of the generalised MNL model were employed to ensure the stability of the preference estimates. The most and least-valued states were the top and bottom levels of the control over daily life attribute. The preference weights were not on a cardinal scale. We observed the position effect of the attributes on preferences associated with the best or second-best choices. A learning effect was found. The established preference weights can be used in evaluations of the effects of long-term care services and interventions on the quality of life of service users and caregivers. The learning effect implies a need to develop study designs that ensure equal consideration to all profiles (choice tasks) in a sequential choice experiment.
Highlights
The provision of long-term care (LTC) for older people in various OECD countries has been substantially contributed to by informal carers [1]
Systematic reviews [10, 11] indicate that informal carers’ well-being, stress or burden, mental health, needs and experience have been measured by a number of measures, such as the Caregiver Burden Interview [12], the CES Depression Scale [13] and the Social Satisfaction Scale [14]
The use of appropriate measures and methods to assess the costs and outcomes related to the provision of informal care and the quality of life (QoL) of carers has become important in effectiveness and cost-effectiveness studies that include informal care [15]
Summary
The provision of long-term care (LTC) for older people in various OECD countries has been substantially contributed to by informal carers [1]. Systematic reviews [10, 11] indicate that informal carers’ well-being, stress or burden, mental health, needs and experience have been measured by a number of measures, such as the Caregiver Burden Interview [12], the CES Depression Scale [13] and the Social Satisfaction Scale [14]. Since these measures focus on specific aspects of carers’ well-being, they may omit outcomes or experiences that are important to carers. The use of appropriate measures and methods to assess the costs and outcomes related to the provision of informal care and the QoL of carers has become important in effectiveness and cost-effectiveness studies that include informal care [15]
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