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A Systematic Review of Stated Preference Studies Reporting Public Preferences for Healthcare Priority Setting

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Abstract

Background

There is current interest in incorporating weights based on public preferences for health and healthcare into priority-setting decisions.

Objective

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.

Methods

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.

Results

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.

Conclusions

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.

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Abbreviations

CUA:

Cost–utility analysis

CV:

Contingent valuation

DCE:

Discrete choice experiment

MCDA:

Multicriteria decision analysis

PTO:

Person trade-off

QALY:

Quality adjusted life year

QoL:

Quality of Life

WTP:

Willingness to pay

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Acknowledgments

None declared.

Funding source

None declared.

Conflict of interest

None declared.

Author contributions

This review was undertaken in response to an invitation from The Patient. JW, EL, KR and JR developed the review scope and methods. KR, XG and JW selected studies for inclusion, extracted information and classified the studies. JW synthesised the review findings and drafted the manuscript. KR and XG assisted with manuscript drafting. EL and JR assisted with interpretation of the findings from the literature synthesis. All authors critically reviewed the manuscript for intellectual content and approved the final version. JW is overall guarantor for the paper.

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Authors and Affiliations

  1. School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, 20 Cornwall Street, Woolloongabba, Brisbane, QLD, 4102, Australia

    Jennifer A. Whitty

  2. Centre for Applied Health Economics, School of Medicine and Population and Social Health Research Programme, Griffith Health Institute, Griffith University, Logan Campus, Meadowbrook, QLD, Australia

    Jennifer A. Whitty, Kylie Rixon & Xanthe Golenko

  3. Centre for Health Economics, Faculty of Business and Economics, Monash University, Melbourne, VIC, Australia

    Emily Lancsar

  4. Flinders Health Economics Group, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia

    Julie Ratcliffe

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  1. Jennifer A. Whitty
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Correspondence to Jennifer A. Whitty.

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Whitty, J.A., Lancsar, E., Rixon, K. et al. A Systematic Review of Stated Preference Studies Reporting Public Preferences for Healthcare Priority Setting. Patient 7, 365–386 (2014). https://doi.org/10.1007/s40271-014-0063-2

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