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Understanding the formation and influence of attitudes in patients' treatment choices for lower back pain: Testing the benefits of a hybrid choice model approach

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  • Kløjgaard, Mirja Elisabeth
  • Hess, Stephane

Abstract

A growing number of studies across different fields are making use of a new class of choice models, labelled variably as hybrid model structures or integrated choice and latent variable models, and incorporating the role of attitudes in decision making. To date, this technique has not been used in health economics. The present paper looks at the formation of such attitudes and their role in patients' treatment choices in the context of low back pain. We use stated choice data collected from a sample of 561 patients with 348 respondents referred to a regional spine centre in Middelfart, Denmark in spring/summer 2012. We show how the hybrid model structure is able to make a link between attitudinal questions and treatment choices, and also explains variation of these attitudes across key socio-demographic groups. However, we also show how, in this case, only a small share of the overall heterogeneity is linked to the latent attitude construct. Despite their growing popularity, the key findings of the advanced model, despite a greater insight into the drivers of attitudes and small gains in efficiency, are no different from standard approaches which remain easier to apply.

Suggested Citation

  • Kløjgaard, Mirja Elisabeth & Hess, Stephane, 2014. "Understanding the formation and influence of attitudes in patients' treatment choices for lower back pain: Testing the benefits of a hybrid choice model approach," Social Science & Medicine, Elsevier, vol. 114(C), pages 138-150.
    • Handle: RePEc:eee:socmed:v:114:y:2014:i:c:p:138-150
    DOI: 10.1016/j.socscimed.2014.05.058
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    References listed on IDEAS

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    1. Hole, Arne Risa, 2008. "Modelling heterogeneity in patients' preferences for the attributes of a general practitioner appointment," Journal of Health Economics, Elsevier, vol. 27(4), pages 1078-1094, July.
    2. Stephane Hess & Nesha Beharry-Borg, 2012. "Accounting for Latent Attitudes in Willingness-to-Pay Studies: The Case of Coastal Water Quality Improvements in Tobago," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 52(1), pages 109-131, May.
    3. Hess, Stephane & Train, Kenneth E. & Polak, John W., 2006. "On the use of a Modified Latin Hypercube Sampling (MLHS) method in the estimation of a Mixed Logit Model for vehicle choice," Transportation Research Part B: Methodological, Elsevier, vol. 40(2), pages 147-163, February.
    4. Ben-Akiva, Moshe & McFadden, Daniel & Train, Kenneth & Börsch-Supan, Axel, 2002. "Hybrid Choice Models: Progress and Challenges," Sonderforschungsbereich 504 Publications 02-29, Sonderforschungsbereich 504, Universität Mannheim;Sonderforschungsbereich 504, University of Mannheim.
    5. Andrew Daly & Stephane Hess & Bhanu Patruni & Dimitris Potoglou & Charlene Rohr, 2012. "Using ordered attitudinal indicators in a latent variable choice model: a study of the impact of security on rail travel behaviour," Transportation, Springer, vol. 39(2), pages 267-297, March.
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    Cited by:

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    3. Mariel, Petr & Meyerhoff, Jürgen & Hess, Stephane, 2015. "Heterogeneous preferences toward landscape externalities of wind turbines – combining choices and attitudes in a hybrid model," Renewable and Sustainable Energy Reviews, Elsevier, vol. 41(C), pages 647-657.
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    6. Joanna Mazur & Katarzyna Śledziewska & Damian Zieba, 2018. "Regulation of Geo-blocking: does it address the problem of low intraEU iTrade?," Working Papers 2018-20, Faculty of Economic Sciences, University of Warsaw.
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