IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v70y2010i10p1536-1543.html
   My bibliography  Save this article

Understanding the impact of economic evidence on clinical decision making: A discrete choice experiment in cardiology

Author

Listed:
  • Torbica, Aleksandra
  • Fattore, Giovanni

Abstract

The present study aims to evaluate the impact of cost-effectiveness information on clinical decision making using discrete choice experiment (DCE) methodology. Data were collected through a self-completed questionnaire administered to Italian cardiologists in June 2007 (n = 129 respondents, 1143 observations). The questionnaire asked clinicians to make choices between paired scenarios, across which three key dimensions were identified and varied: (1) quality of clinical evidence, (2) size of health gain (reduction of relative and absolute risk), and (3) economic impact (incremental cost-effectiveness ratio). A random effects probit model was used to estimate clinicians' preferences for the different dimensions, while the heterogeneity of preferences was tested in a model with interaction terms. Dominance tests were used to assess the consistency of responses. The results indicate that Italian cardiologists regard economic impact (cost-effectiveness) as an important factor in their decision making. Economic evidence is valued more highly among clinicians with a higher self-assessed level of knowledge regarding economic evaluation techniques, as well as among younger professionals (age

Suggested Citation

  • Torbica, Aleksandra & Fattore, Giovanni, 2010. "Understanding the impact of economic evidence on clinical decision making: A discrete choice experiment in cardiology," Social Science & Medicine, Elsevier, vol. 70(10), pages 1536-1543, May.
    • Handle: RePEc:eee:socmed:v:70:y:2010:i:10:p:1536-1543
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(10)00052-3
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Ray Wu, 2004. "Making an impact," Nature, Nature, vol. 428(6979), pages 206-207, March.
    2. Cappellaro, Giulia & Fattore, Giovanni & Torbica, Aleksandra, 2009. "Funding health technologies in decentralized systems: A comparison between Italy and Spain," Health Policy, Elsevier, vol. 92(2-3), pages 313-321, October.
    3. Emily Lancsar & Jordan Louviere, 2008. "Conducting Discrete Choice Experiments to Inform Healthcare Decision Making," PharmacoEconomics, Springer, vol. 26(8), pages 661-677, August.
    4. Williams, Iestyn & Bryan, Stirling, 2007. "Understanding the limited impact of economic evaluation in health care resource allocation: A conceptual framework," Health Policy, Elsevier, vol. 80(1), pages 135-143, January.
    5. Ryan, Mandy & Netten, Ann & Skatun, Diane & Smith, Paul, 2006. "Using discrete choice experiments to estimate a preference-based measure of outcome--An application to social care for older people," Journal of Health Economics, Elsevier, vol. 25(5), pages 927-944, September.
    6. Ubel, Peter A. & Jepson, Christopher & Baron, Jonathan & Hershey, John C. & Asch, David A., 2003. "The influence of cost-effectiveness information on physicians' cancer screening recommendations," Social Science & Medicine, Elsevier, vol. 56(8), pages 1727-1736, April.
    7. Rob Baltussen & Elly Stolk & Dan Chisholm & Moses Aikins, 2006. "Towards a multi‐criteria approach for priority setting: an application to Ghana," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 689-696, July.
    8. Louviere,Jordan J. & Hensher,David A. & Swait,Joffre D. With contributions by-Name:Adamowicz,Wiktor, 2000. "Stated Choice Methods," Cambridge Books, Cambridge University Press, number 9780521788304, October.
    9. Eddama, Oya & Coast, Joanna, 2008. "A systematic review of the use of economic evaluation in local decision-making," Health Policy, Elsevier, vol. 86(2-3), pages 129-141, May.
    10. Scott, Anthony, 2001. "Eliciting GPs' preferences for pecuniary and non-pecuniary job characteristics," Journal of Health Economics, Elsevier, vol. 20(3), pages 329-347, May.
    11. Scott, Anthony, 2002. "Identifying and analysing dominant preferences in discrete choice experiments: An application in health care," Journal of Economic Psychology, Elsevier, vol. 23(3), pages 383-398, June.
    12. Kapiriri, Lydia & Norheim, Ole Frithjof & Martin, Douglas K., 2007. "Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda," Health Policy, Elsevier, vol. 82(1), pages 78-94, June.
    13. Fredrik Carlsson & Peter Martinsson, 2003. "Design techniques for stated preference methods in health economics," Health Economics, John Wiley & Sons, Ltd., vol. 12(4), pages 281-294, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Chiara Seghieri & Alessandro Mengoni & Sabina Nuti, 2014. "Applying discrete choice modelling in a priority setting: an investigation of public preferences for primary care models," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(7), pages 773-785, September.
    2. Carr, Michelle & Beck, Matthias, 2022. "Accounting practices and professional power dynamics during a crisis," The British Accounting Review, Elsevier, vol. 54(3).
    3. Maria C. McCarthy & Richard De Abreu Lourenco & Laura J. McMillan & Elena Meshcheriakova & Alice Cao & Lynn Gillam, 2020. "Finding Out What Matters in Decision-Making Related to Genomics and Personalized Medicine in Pediatric Oncology: Developing Attributes to Include in a Discrete Choice Experiment," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 13(3), pages 347-361, June.
    4. Michael Clark & Domino Determann & Stavros Petrou & Domenico Moro & Esther Bekker-Grob, 2014. "Discrete Choice Experiments in Health Economics: A Review of the Literature," PharmacoEconomics, Springer, vol. 32(9), pages 883-902, September.
    5. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    6. Mark Harrison & Dan Rigby & Caroline Vass & Terry Flynn & Jordan Louviere & Katherine Payne, 2014. "Risk as an Attribute in Discrete Choice Experiments: A Systematic Review of the Literature," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 7(2), pages 151-170, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Emily Lancsar & Peter Burge, 2014. "Choice modelling research in health economics," Chapters, in: Stephane Hess & Andrew Daly (ed.), Handbook of Choice Modelling, chapter 28, pages 675-687, Edward Elgar Publishing.
    2. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    3. Chiara Seghieri & Alessandro Mengoni & Sabina Nuti, 2014. "Applying discrete choice modelling in a priority setting: an investigation of public preferences for primary care models," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(7), pages 773-785, September.
    4. Amilon, Anna & Ladenburg, Jacob & Siren, Anu & Vernstrøm Østergaard, Stine, 2020. "Willingness to pay for long-term home care services: Evidence from a stated preferences analysis," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    5. Julia Witt & Anthony Scott & Richard H. Osborne, 2009. "Designing choice experiments with many attributes. An application to setting priorities for orthopaedic waiting lists," Health Economics, John Wiley & Sons, Ltd., vol. 18(6), pages 681-696, June.
    6. Joanna Coast & Hareth Al‐Janabi & Eileen J. Sutton & Susan A. Horrocks & A. Jane Vosper & Dawn R. Swancutt & Terry N. Flynn, 2012. "Using qualitative methods for attribute development for discrete choice experiments: issues and recommendations," Health Economics, John Wiley & Sons, Ltd., vol. 21(6), pages 730-741, June.
    7. Carlsen, Benedicte & Hole, Arne Risa & Kolstad, Julie Riise & Norheim, Ole Frithjof, 2012. "When you can’t have the cake and eat it too," Social Science & Medicine, Elsevier, vol. 75(11), pages 1964-1973.
    8. Terry Flynn, 2010. "Using Conjoint Analysis and Choice Experiments to Estimate QALY Values," PharmacoEconomics, Springer, vol. 28(9), pages 711-722, September.
    9. Shah, Koonal K. & Tsuchiya, Aki & Wailoo, Allan J., 2015. "Valuing health at the end of life: A stated preference discrete choice experiment," Social Science & Medicine, Elsevier, vol. 124(C), pages 48-56.
    10. Hoyos, David, 2010. "The state of the art of environmental valuation with discrete choice experiments," Ecological Economics, Elsevier, vol. 69(8), pages 1595-1603, June.
    11. Waleska Sigüernza & Petr Mariel, 2013. "Valoración económica de los servicios sanitarios en la Comunidad Autónoma del País Vasco," Hacienda Pública Española / Review of Public Economics, IEF, vol. 207(4), pages 71-99, December.
    12. Brigitte Essers & Debby Helvoort-Postulart & Martin Prins & Martino Neumann & Carmen Dirksen, 2010. "Does the Inclusion of a Cost Attribute Result in Different Preferences for the Surgical Treatment of Primary Basal Cell Carcinoma?," PharmacoEconomics, Springer, vol. 28(6), pages 507-520, June.
    13. Bansback, Nick & Brazier, John & Tsuchiya, Aki & Anis, Aslam, 2012. "Using a discrete choice experiment to estimate health state utility values," Journal of Health Economics, Elsevier, vol. 31(1), pages 306-318.
    14. Harry Telser & Karolin Becker & Peter Zweifel, 2008. "Validity and Reliability of Willingness-to-Pay Estimates," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 1(4), pages 283-298, October.
    15. Mandy Ryan & Karen Gerard & Gillian Currie, 2012. "Using Discrete Choice Experiments in Health Economics," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 41, Edward Elgar Publishing.
    16. Sivey, Peter & Scott, Anthony & Witt, Julia & Joyce, Catherine & Humphreys, John, 2012. "Junior doctors’ preferences for specialty choice," Journal of Health Economics, Elsevier, vol. 31(6), pages 813-823.
    17. Hoyos Ramos, David, 2010. "Using discrete choice experiments for environmental valuation," BILTOKI 1134-8984, Universidad del País Vasco - Departamento de Economía Aplicada III (Econometría y Estadística).
    18. Olof Johansson‐Stenman & Minhaj Mahmud & Peter Martinsson, 2011. "Saving lives versus life‐years in rural Bangladesh: an ethical preferences approach," Health Economics, John Wiley & Sons, Ltd., vol. 20(6), pages 723-736, June.
    19. Bansback, Nick & Brazier, John & Tsuchiya, Aki & Anis, Aslam, 2010. "Using a discrete choice experiment to estimate societal health state utility values," MPRA Paper 29933, University Library of Munich, Germany.
    20. Jesús Clemente López & Pedro García Castrillo & María A. González Alvarez & Marcos Sanso Frago, 2014. "Una evaluación de la efectividad de la formación ocupacional para desempleados antes y después de la crisis económica: el caso de Aragón," Hacienda Pública Española / Review of Public Economics, IEF, vol. 208(1), pages 77-106, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:70:y:2010:i:10:p:1536-1543. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.