Choice Experiment Method Research Articles

Measuring Preferences for a Diabetes Pay-for-Performance for Patient (P4P4P) Program using a Discrete Choice Experiment

ObjectiveTo elicit a patient’s willingness to participate in a diabetes pay-for-performance for patient (P4P4P) program using a discrete choice experiment method. MethodsThe survey was conducted in March 2013. Our sample was drawn from patients with diabetes at five hospitals in Taiwan (International Classification of Diseases, Ninth Revision, Clinical Modification code 250). The sample size was 838 patients. The discrete choice experiment questionnaire included the attributes monthly cash rewards, exercise time, diet control, and program duration. We estimated a bivariate probit model to derive willingness-to-accept levels after accounting for the characteristics (e.g., severity and comorbidity) of patients with diabetes. ResultsThe preferred program was a 3-year program involving 30 minutes of exercise per day and flexible diet control. Offering an incentive of approximately US $67 in cash per month appears to increase the likelihood that patients with diabetes will participate in the preferred P4P4P program by approximately 50%. ConclusionsPatients with more disadvantageous characteristics (e.g., elderly, low income, greater comorbidity, and severity) could have less to gain from participating in the program and thus require a higher monetary incentive to compensate for the disutility caused by participating in the program’s activities. Our result demonstrates that a modest financial incentive could increase the likelihood of program participation after accounting for the attributes of the P4P4P program and patients’ characteristics.

Investigating demand for biofortified seeds in developing countries

Purpose – The purpose of this paper is to explore farmer acceptance of a biofortified staple food crop in a developing country prior to its commercialization. The paper focuses on the hypothetical introduction of a high-iron pearl millet variety in Maharashtra, India, where pearl millet is among the most important staple crops. Design/methodology/approach – A choice experiment is used to investigate farmer preferences for and trade-offs among various production and consumption attributes of pearl millet. The key pearl millet attributes studied include days it takes pearl millet to mature, color of the roti (flat bread) the grain produces, the presence of high-iron content (nutritional attribute), and the price of the pearl millet seed. Choice data come from 630 pearl millet-producing households from three purposefully selected districts of Maharashtra. A latent class model is used to investigate the heterogeneity in farmers’ preferences for pearl millet attributes and to profile farmers who are more or less likely to choose high-iron varieties of pearl millet. Findings – The results reveal that there are three distinct segments in the sample, and there is significant heterogeneity in farmer preferences across these segments. High-iron pearl millet is valued the most by larger households that produce mainly for household consumption and currently have lower quality diets. Households that mainly produce for market sales, on the other hand, derive lower benefits from consumption characteristics such as color and nutrition. Research limitations/implications – The main limitation of the study is that it uses a stated preference choice experiment method, which suffers from hypothetical bias. At the time of implementing this study biofortified high-iron pearl millet varieties were not yet developed, therefore the authors could not have implemented revealed preference elicitation methods with real products and payment. Originality/value – The method used (stated preference choice experiment method) is commonly used to value non-market goods such as environmental goods and products that are not yet in the market. It’s application to agriculture and in developing countries is increasing. As far as the authors know this is the first choice experiment implemented to investigate farmer/consumer preferences for biofortified crops. The study presents valuable information for development and delivery of biofortified crops for reducing micronutrient deficiencies.

Ecosystem benefits from coastal habitats—A three-country choice experiment

Coastal habitats provide a variety of benefits for citizens living in littoral countries. The economic value of changes in coastal habitats in the context of the implementation of the Baltic Sea Action Plan, targeting good ecological status by 2021, in two coastal sites was estimated using the choice experiment method. The selected aspects of marine ecosystem were described in conjunction with ecological changes modeled within the Finnish–Swedish archipelago and the Lithuanian coast. The benefits for Finns, Swedes, and Lithuanians for changes in the adjacent coastal site were estimated with the conditional logit and random parameters logit models accounting for preference heterogeneity. The willingness to pay estimates for healthy perennial vegetation, protection of currently pristine areas, and size of fish stocks differed significantly between populations. The transfer errors ranging from 40%, when transferring the estimates for the same coastal site between populations, to 400%, when transferring between both sites and populations, underline careful consideration in value transfers.

Chinese students and higher education destinations: Findings from a choice experiment

This paper presents a novel application of a discrete choice experiment that seeks to contribute to a more accurate understanding of international education flows. The discrete choice experiment method is employed to identify the key factors underlying students’ international education choices. The specific focus in the study is on China as the largest origin country of international students in the growing global education market. Data are collected from a sample of prospective Chinese outbound students. The findings suggest that university ranking and destination safety are key decision drivers for Chinese students. The results have policy implications for Australia, as one of the key higher education destination countries, for instance, in relation to recently changed student visa systems and the potential effects of planned government budget cuts to higher education on educational quality and reputation.

Consumer motivation and willingness to pay for “safer” vegetables in Ghana

Purpose– The purpose of this paper is to assess consumer motivation and willingness to pay (WTP) for “safer” vegetables from the use of non-treatment options of wastewater use in urban/peri-urban vegetable production.Design/methodology/approach– As a theoretical basis, consumer theory of maximizing utility being an indicator of individual preference was examined through choice experiment (CE) method to measure the WTP for value of safety within the context of health reduced risk (pathogen reduction) of illness. WTP was tested empirically using survey data from 650 households in the two largest cities in Ghana (Accra and Kumasi) that are characterized by a number of well-established vegetable producers who use wastewater in their production and a large urban and peri-urban vegetable consumer market.Findings– Experience of vegetable borne diseases drives the need for safer vegetables and income and gender are key demographic factors influencing WTP. It was further found that consumers are willing to pay an average amount of GH¢ 4.7 ($2.40) per month for a technology change that would result in the production of “safer” vegetables.Research limitations/implications– Understanding WTP offers insight into consumer concerns, behaviour and their readiness to pay for safer vegetable options. However, a further consideration of the impact of the combinations of the various non-treatment options on pathogen reduction and the assessment of the financial viability of each option will collectively ensure an efficient and cost-effective implementation of the technologies.Practical implications– WTP insight gained has implications for vegetable production, marketing and public health policy. The understanding from the findings forms a solid basis to canvass for certification system for urban/peri urban vegetables. The information provided also helps to formulate effective public education on the safety of vegetables.Originality/value– Measuring WTP for safer vegetables by Ghanaian urban/peri-urban consumers is novel. The CE approach is robust and the findings can inform vegetable production and marketing decisions as well as public health policy formulation.

Consumer preferences for agricultural products considering the value of biodiversity conservation in the Mekong Delta, Vietnam

Because biodiversity conservation is a crucial aspect of multifunctionality in agriculture, consumers may be willing to pay a higher premium for products with environmentally friendly farming techniques to preserve biodiversity. To analyze the effects of biodiversity on the market price of agricultural products, this study applied the choice experiment method to assess consumers’ preferences for environmentally certified rice (termed “crane-friendly farming”) proposed for growth in Tram Chim National Park, one of Vietnam's eight important bird areas. Our results indicate that the majority of Vietnamese Mekong Delta consumers agreed to buy the proposed environmentally certified rice. They were willing to pay a premium of VND 11 for one kilogram of environmentally certified rice to increase crane numbers and VND 1500 for a 100% increase in the biodiversity level. In addition, their implicit price for rice cultivation without chemical pesticides (organic rice) was VND 6200, a 62% premium over the price of normal rice.

Systematic Review of Patients' and Parents' Preferences for ADHD Treatment Options and Processes of Care.

Patient preferences are an important topic of study with respect to attention-deficit hyperactivity disorder (ADHD) interventions, as there are multiple treatment choices available, multiple developmental levels to consider, and multiple potential individuals involved in treatment (children, parents, and adults with ADHD). Stated preference methods such as discrete choice experiment (DCE), best-worst scaling (BWS), and other utility value methods such as standard gamble interview (SGI) and time trade-off (TTO) are becoming more common in research addressing preferences for ADHD treatments. A synthesis of this research may facilitate improved patient-centered and family-centered treatment for ADHD. The purpose of this review was to synthesize reports across existing DCE, BWS, TTO, and SGI studies to assess which aspects of ADHD treatment are most studied as well as most preferred and influential in treatment decisions. MEDLINE, PsycINFO. A total of 41 studies referring to preferences for ADHD treatment were identified through the initial search and contact with researchers. Of these, 13 reported ADHD treatment preference data from a study using DCE, BWS, or SGI methods. No TTO studies were identified that met inclusion criteria. Methods and designs varied considerably across studies. Relatively few studies focused on preferences among children, adolescents, and adults compared with those that focused on the preferences of parents of children with ADHD. The majority of studies focused primarily on medication treatments, with many fewer focused on psychosocial treatments. Some studies indicated that parents of children with ADHD prefer to avoid stimulant medications in favor of behavioral or psychosocial interventions. Others report that parents see medication as a preferred treatment. Treatment outcome is a particularly salient attribute for treatment decisions for many informants. Potential outcomes of various treatments play a proximal role in patients' and families' decisions for ADHD treatment. Because the majority of studies focus on medication treatments for children with ADHD, more research is necessary to understand preferences related to behavioral and other psychosocial treatments both as stand-alone interventions and used in combination with medication. Additional research is also needed to assess the treatment preferences of adults with ADHD. In general, DCE, BWS, and SGI methods allow measurement of patient preferences in a manner that approximates the uncertainty and trade-offs inherent in real-world treatment decision making and provides valuable information to inform patient-centered and family-centered treatment.

Using the choice experiment method in the design of breeding goals in dairy sheep

Market failures are the main cause of poor acknowledgement of the true impact of functional sheep traits on the management and economic performance of farms, which results in their omission from the breeding goal or the estimation of non-representative economic weights in the breeding goal. Consequently, stated-preference non-market valuation techniques, which recently emerged to mitigate these problems, are necessary to estimate economic weights for functional traits. The purpose of this paper is to present an example of the use of a choice experiment (CE) in the estimation of economic weights for sheep traits for the design of breeding goals. Through a questionnaire survey the preferences of sheep farmers are recorded and their marginal willingness to pay (MWTP) for 10 production and functional traits is estimated. Data are analysed using random parameter logit models. The results reveal unobserved preference heterogeneity for fertility, adaptability to grazing and resistance to disease, thus highlighting that these traits are appreciated differently by farmers, because their needs are diverse. Positive MWTP is found for Greek breeds, high milk production and lambs with low fat deposition, for which there is high demand in Greek markets. On the other hand, MWTP for the cheese-making ability of milk is negative, stemming from the fact that sheep milk prices in Greece are not formulated according to milk composition. In addition, farmers seem to understand differences between udder shapes and attribute different values to various types. This application of the CE method indicates that communication channels among farmers and breeders should be established in order to enhance market performance and to provide orientation to the design of breeding programmes. Non-market valuation can be used complementarily to market valuation techniques, in order to provide accurate estimates for production and functional traits.

Eliciting Smallholder Farmers’ Tradeoffs and Preferences on the Attributes of Climate Smart Agriculture in the Breadbasket Areas of Tanzania Using a Conjoint Experiment Method

While policy and decision-makers are striving to enhance food security amidst maddening impacts of climate change, climate smart agriculture is thought of as a promising breakthrough for responding to climate change impacts in Tanzania and elsewhere in the world as it strives to increase food productivity; build resilience of agricultural systems to climate change impacts and reduce agricultural greenhouse gas emission. Studies show that agricultural sector is both, a cause and a victim of climate change. It significantly contributes greenhouse gases to the atmosphere. However, achieving climate change mitigation through agriculture without compromising food security is a huge policy and research challenge, some scientists say, it is practically impossible. This study sought to determine tradeoffs and preferences of smallholder farmers on the attributes climate smart agricultural practices, specifically modeling choices of smallholder farmers using choice experiment method. Upon estimating three different models, positive utilities were observed in high productivity, Moderate and low GHG emission as well as on moderate and high resilient farming systems. Smallholder farmers showed a complete disutility on low and moderate agricultural productivity, high GHG emission and low resilient farming systems. The models therefore justified the fact that, attaining more yield without a compromise in greenhouse gas emission reduction targets is a blue-sky dream. In order to concisely inform policy, more research on farmers’ preference and tradeoff on the attributes is needed to establish a scientific and logical progression about the tradeoffs people are willing to make with regard to the attributes of climate smart agriculture practices.

Combien les résidents sont-ils disposés à payer pour des améliorations de la qualité de l’eau ? Une application simultanée de la méthode d’expériences des choix à quatre sites récréatifs d’un bassin hydrographique

HowMuch Are ResidentsWilling to Pay for Improvements inWater Quality ? A Simultaneous Application of the Choice Experiment Method to Four River-Basin Recreation Sites. Using the choice experiment method, this paper examines local residents’ preferences for water quality management along a specific river basin in France. We defined site-specific attributes, setting their levels to reflect currentwater quality and an improved quality. We then combined the levels to produce different water management options, each associated with a “ monetary price”. We estimated the value attached by residents to water quality improvement at each site from their choice of management options. Results show that local residents are willing to pay for improvements in water quality.

Contingent valuation and choice experiment of citizens’ willingness to pay for forest conservation in southern Finland

Environmental quality has a direct effect on citizens’ welfare. To quantify this effect, the four articles of this thesis analyse Finnish citizens’ willingness to pay (WTP) for increased forest conservation using the contingent valuation (CV) and choice experiment (CE) methods. These methods are based on neo-classical welfare economics augmented with the choice process framework originating from psychology and behavioural economics. Using the CV method, we analyse how WTP is affected by respondents’ uncertainty, by the share of nonrespondents and by the considerably high share of “yes” responses at the highest proposed costs to households. The CE data are used to study the effects of different conservation programme characteristics on WTP. The results show that Finnish citizens support increased forest conservation. The median WTP in the contingent valuation was 72 EUR, i.e. 50% of respondents supported increased conservation if the costs per household did not exceed 72 EUR. The mean WTP estimates were sensitive to modelling assumptions and assumptions concerning the nonrespondent preferences. This emphasises the need for careful sensitivity analyses when results are used for welfare measurement and policy planning. Respondents’ choices in the valuation questions were affected by the household costs of conservation and other socioeconomic characteristics. The results suggest that the choices in valuation tasks are affected by economic and psychological factors. The study gives important insights into the choice behaviour and lower and upper bound estimates of WTP. These estimates are somewhat lower than those in comparable earlier Finnish studies. In CV, respondents seemed insensitive to programme size while the extent of the proposed project had a significant effect on the choices in CE.

Monetizing the impacts of climate change on river uses towards effective adaptation strategies

This paper examines public preferences for adaptation to climate change of ecosystem services provided by the Piave River in Italy, using the choice experiment method. Climate change projections indicate a considerable precipitation decrease in the broader basin area leading to river discharge loss the forthcoming decades. The study design accounted for preservation of current levels of different river services such as: irrigation, rafting activities, hydroelectricity power and ecological services. Our estimation strategy consisted in estimating a conditional logit model and a random parameters logit, together with their extended forms with census and attitudinal interacted variables. Results from all models present a tendency towards the selection of adaptation alternatives, showing that people are willing to pay for all river services except for rafting activities. Preferences’ heterogeneity proves to be present and determinant, illustrating the choice patterns. The policy implications of these results may assist in developing more robust adaptation practises to cope with the socio-economic impacts of climate change on water resources.

A framework for estimating health state utility values within a discrete choice experiment: modeling risky choices.

There has been recent interest in using the discrete choice experiment (DCE) method to derive health state utilities for use in quality-adjusted life year (QALY) calculations, but challenges remain. We set out to develop a risk-based DCE approach to derive utility values for health states that allowed 1) utility values to be anchored directly to normal health and death and 2) worse than dead health states to be assessed in the same manner as better than dead states. Furthermore, we set out to estimate alternative models of risky choice within a DCE model. A survey was designed that incorporated a risk-based DCE and a "modified" standard gamble (SG). Health state utility values were elicited for 3 EQ-5D health states assuming "standard" expected utility (EU) preferences. The DCE model was then generalized to allow for rank-dependent expected utility (RDU) preferences, thereby allowing for probability weighting. A convenience sample of 60 students was recruited and data collected in small groups. Under the assumption of "standard" EU preferences, the utility values derived within the DCE corresponded fairly closely to the mean results from the modified SG. Under the assumption of RDU preferences, the utility values estimated are somewhat lower than under the assumption of standard EU, suggesting that the latter may be biased upward. Applying the correct model of risky choice is important whether a modified SG or a risk-based DCE is deployed. It is, however, possible to estimate a probability weighting function within a DCE and estimate "unbiased" utility values directly, which is not possible within a modified SG. We conclude by setting out the relative strengths and weaknesses of the 2 approaches in this context.

Using a choice experiment to estimate the social benefits from improved water supply services

Efficient and sustainable future investments in water infrastructure and improved water services should be based on a thorough understanding of public preferences and values. This paper examines the welfare effects of improved water supply services in a characteristic coastal area, where water policy makers should address both water quality and water quantity problems. A choice experiment method was designed and conducted in order to evaluate public preferences for alternative levels of water supply attributes: i.e. water quality, frequency of water supply interruptions and water availability for agriculture. Primary data were collected using a structured questionnaire from a sample of residents in the study area (Municipality of New Propontida, Greece). The results show a significant willingness to pay (WTP) for drinking water quality improvements and a lower yet important WTP to avoid interruptions in water services. In a cost-benefit framework, those findings may serve as a reference for sustainable water resources planning, aiming at deriving reliable estimates of social benefits from selected water management decisions.

An Actual Purchasing Experiment for Investigating the Effects of Eco-Information on Consumers’ Environmental Consciousness and Attitudes Towards Agricultural Products

This study investigates the effects of eco-information on the environmental consciousness and attitudes of consumers towards agricultural products. We focus on Japanese rice to provide recommendations to protect the Ibis, an endangered bird in Japan, and evaluate how Ecologically Conscious Consumer Behavior (ECCB) affect consumers’ Willingness To Pay (WTP) via the choice experiment method. Participants are provided with the necessary eco-information pertaining to rice production, and are required to taste and purchase the rice. The results indicate that consumers with high ECCB display higher WTP after they are provided with the necessary eco-information pertaining to rice production.

Monetary valuation in Life Cycle Assessment: a review

Abstract Monetary valuation is the practice of converting measures of social and biophysical impacts into monetary units and is used to determine the economic value of non-market goods, i.e. goods for which no market exists. It is applied in cost benefit analysis to enable the cross-comparison between different impacts and/or with other economic costs and benefits. For this reason, monetary valuation has a great potential to be applied also in Life Cycle Assessment (LCA), especially in the weighting phase. However, several challenges limit its diffusion in the field, which resulted in only a few applications so far. The authors have performed a review of different monetary valuation methods for use in LCA. Firstly, monetary valuation approaches, methods, and LCA applications were identified. Secondly, key features and the strengths and weaknesses of each monetary valuation method were determined. Finally, monetary valuation methods and LCA applications were evaluated according to a comprehensive set of criteria, ranging from scientific foundation to uncertainty and complexity. It was found that observed- and revealed-preference methods and the abatement cost method have limited applicability in LCA, whereas the choice experiment method and the budget constraint method are the best options for monetary valuation in LCA.

Empirical Testing of the External Validity of a Discrete Choice Experiment to Determine Preferred Treatment Option: The Case of Sleep Apnea.

There is an increasing use of the discrete choice experiment (DCE) method in health care to estimate preferences of individuals and the public for different services. Despite this increasing use, there are few studies that investigate the validity of the DCE in health. This study investigates the external validity of DCE by comparing the predicted treatment choices from the DCE to the actual treatment choices made by the same respondents using a decision board (DB) approach. The sample includes 140 patients who came for a sleep apnea routine visit in a hospital setting. Each respondent answered 10 DCE tasks and 1 DB task. The preferences were estimated with a generalized multinomial logit model and the predicted and actual treatment choices were compared both at the sample and individual levels. The results raise questions about the external validity of DCE in health. At the sample level, the comparison showed large but not significant differences between the two methods. This can be explained in part by the aggregation process that obscures variability in the individuals' preferences. At the individual level, the comparison showed that the two methods led to significantly different patterns of choices.

A systematic review of stated preference studies reporting public preferences for healthcare priority setting.

There is current interest in incorporating weights based on public preferences for health and healthcare into priority-setting decisions. The aim of this systematic review was to explore the extent to which public preferences and trade-offs for priority-setting criteria have been quantified, and to describe the study contexts and preference elicitation methods employed. A systematic review was performed in April 2013 to identify empirical studies eliciting the stated preferences of the public for the provision of healthcare in a priority-setting context. Studies are described in terms of (i) the stated preference approaches used, (ii) the priority-setting levels and contexts, and (iii) the criteria identified as important and their relative importance. Thirty-nine studies applying 40 elicitation methods reported in 41 papers met the inclusion criteria. The discrete choice experiment method was most commonly applied (n = 18, 45.0 %), but other approaches, including contingent valuation and the person trade-off, were also used. Studies prioritised health systems (n = 4, 10.2 %), policies/programmes/services/interventions (n = 16, 41.0 %), or patient groups (n = 19, 48.7 %). Studies generally confirmed the importance of a wide range of process, non-health and patient-related characteristics in priority setting in selected contexts, alongside health outcomes. However, inconsistencies were observed for the relative importance of some prioritisation criteria, suggesting context and/or elicitation approach matter. Overall, findings suggest caution in directly incorporating public preferences as weights for priority setting unless the methods used to elicit the weights can be shown to be appropriate and robust in the priority-setting context.

The Usefulness of the Discrete Choice Experiment in Providing Effective Healthcare

Given that in times of crisis the burden of chronic disease is increasing, preventive interventions are becoming more important as they affect the maintenance and improvement of the population’s health, therefore reducing government spending on the sick leave and disability benefits. As public healthcare is characterized by administrative decision-making and relying on non-market mechanisms in the resource allocation, it requires the implementation of economic evaluations. This discussion shows that because the specifics of public healthcare complicate the data collection of revealed (market) preferences, it is necessary to rely on stated preferences of respondents in order to evaluate the economic value of health interventions as well to improve public health care interventions and make them more patients oriented. Also, this article explores the method of discrete choice experiment along with its applications in healthcare, which seeks to identify the marginal rate of substitution between relevant attributes of public healthcare intervention and its impact on the patients’ choice, hence enabling a broad application of the method.

A think aloud study comparing the validity and acceptability of discrete choice and best worst scaling methods.

ObjectivesThis study provides insights into the validity and acceptability of Discrete Choice Experiment (DCE) and profile-case Best Worst Scaling (BWS) methods for eliciting preferences for health care in a priority-setting context.MethodsAn adult sample (N = 24) undertook a traditional DCE and a BWS choice task as part of a wider survey on Health Technology Assessment decision criteria. A ‘think aloud’ protocol was applied, whereby participants verbalized their thinking while making choices. Internal validity and acceptability were assessed through a thematic analysis of the decision-making process emerging from the qualitative data and a repeated choice task.ResultsA thematic analysis of the decision-making process demonstrated clear evidence of ‘trading’ between multiple attribute/levels for the DCE, and to a lesser extent for the BWS task. Limited evidence consistent with a sequential decision-making model was observed for the BWS task. For the BWS task, some participants found choosing the worst attribute/level conceptually challenging. A desire to provide a complete ranking from best to worst was observed. The majority (18,75%) of participants indicated a preference for DCE, as they felt this enabled comparison of alternative full profiles. Those preferring BWS were averse to choosing an undesirable characteristic that was part of a ‘package’, or perceived BWS to be less ethically conflicting or burdensome. In a repeated choice task, more participants were consistent for the DCE (22,92%) than BWS (10,42%) (p = 0.002).ConclusionsThis study supports the validity and acceptability of the traditional DCE format. Findings relating to the application of BWS profile methods are less definitive. Research avenues to further clarify the comparative merits of these preference elicitation methods are identified.