Unravelling Elements of Value of Healthcare and Assessing their Importance Using Evidence from Two Discrete-Choice Experiments in England

Background Health systems are moving towards value-based care, implementing new care models that allegedly aim beyond patient outcomes. Therefore, a policy and academic debate is underway regarding the definition of value in healthcare, the inclusion of costs in value metrics, and the importance of...

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Bibliographic Details
Published in:PharmacoEconomics 2024-10, Vol.42 (10), p.1145-1159
Main Authors: Gongora-Salazar, Pamela, Perera, Rafael, Rivero-Arias, Oliver, Tsiachristas, Apostolos
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Bayes Theorem
Business metrics
Choice Behavior
Clinical decision making
Consumers
Cost control
Cost-Benefit Analysis
Decision making
Delivery of Health Care - economics
Design
England
Equity
Female
Health Administration
Health Care Costs - statistics & numerical data
Health care expenditures
Health Economics
Humans
Interviews as Topic
Literature reviews
Male
Medicine
Medicine & Public Health
Middle Aged
Original
Original Research Article
Patient Preference
Patient satisfaction
Pharmacoeconomics and Health Outcomes
Preferences
Public Health
Quality of Life
Quality of Life Research
Quality-Adjusted Life Years
Surveys and Questionnaires
Systematic review
Value-based care
Young Adult
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Summary:Background Health systems are moving towards value-based care, implementing new care models that allegedly aim beyond patient outcomes. Therefore, a policy and academic debate is underway regarding the definition of value in healthcare, the inclusion of costs in value metrics, and the importance of each value element. This study aimed to define healthcare value elements and assess their relative importance (RI) to the public in England. Method Using data from 26 semi-structured interviews and a literature review, and applying decision-theory axioms, we selected a comprehensive and applicable set of value-based elements. Their RI was determined using two discrete choice experiments (DCEs) based on Bayesian D-efficient DCE designs, with one DCE incorporating healthcare costs expressed as income tax rise. Respondent preferences were analysed using mixed logit models. Results Six value elements were identified: additional life-years, health-related quality of life, patient experience, target population size, equity, and cost. The DCE surveys were completed by 402 participants. All utility coefficients had the expected signs and were statistically significant ( p  
ISSN:1170-7690
1179-2027
1179-2027
DOI:10.1007/s40273-024-01416-5