Using conjoint analysis to elicit preferences for health care

Abstract

Traditionally the extent of patients' involvement in medical decision making has been minimal. This has been true at both the micro level of the patient consultation with a doctor and the macro level of planning and developing healthcare services. Since 1989, however, greater involvement of patients and the community in these processes has been advocated.1–5 In principle, the elicitation of patients' and the community's values represents a big step forward in terms of enhancing the benefits from the provision of health care. For the exercise to be worth while, however, the information obtained must be useful and scientifically defensible.6 During the 1990s, conjoint analysis was developed to elicit patients' and the community's views on health care. #### Summary points Conjoint analysis is a rigorous method of eliciting preferences It allows estimation of the relative importance of different aspects of care, the trade-offs between these aspects, and the total satisfaction or utility that respondents derive from healthcare services The technique can help with decision making for some of the issues facing the NHS Though further applications of conjoint analysis are encouraged, methodological issues need further consideration This paper explains conjoint analysis, provides examples of applications in health care which were obtained from a systematic review of databases between 1989 and 1999 (Medline, Embase, HealthSTAR, PsychLIT, EconLIT), and uses a study in orthodontic care to show the uses and pitfalls of the technique. The survey method of data collection and analysis known as conjoint analysis was developed in mathematical psychology and has a strong theoretical basis.7–9 It has been successfully used in market research,10 transport economics,11 and environmental economics 12 13 and was recommended to the UK Treasury for valuing quality in the provision of public services.14 Within these areas it has been well received …