Designing Unforced Choice Experiments to Inform Health Care Decision Making: Implications of Using Opt-Out, Neither, or Status Quo Alternatives in Discrete Choice Experiments

Domino Determann, Dorte Gyrd-Hansen, G. Ardine de Wit, Esther W. de Bekker-Grob, Ewout W. Steyerberg, Mattijs S. Lambooij and Line Bjørnskov Pedersen
Additional contact information
Domino Determann: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
Dorte Gyrd-Hansen: DaCHE–Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark, Odense, Denmark
G. Ardine de Wit: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
Esther W. de Bekker-Grob: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
Ewout W. Steyerberg: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
Mattijs S. Lambooij: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
Line Bjørnskov Pedersen: DaCHE–Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark, Odense, Denmark

Medical Decision Making, 2019, vol. 39, issue 6, 681-692

Abstract: Background . Discrete choice experiments (DCEs) are increasingly used in the health care context to inform on patient preferences for health care services. In order for such experiments to provide useful and policy-relevant information, it is vital that the design includes those options that the respondent faces in the real-life situation. Whether to include opt-out, neither, or status quo alternatives has, however, received little attention in the DCE literature. We aim to investigate whether the use of different unforced choice formats affects DCE results in different settings: 1) opt-out versus neither in a health care market where there is no status quo and 2) including status quo in addition to opt-out in a health care market with a status quo. Design . A DCE on Dutch citizens’ preferences for personal health records served as our case, and 3189 respondents were allocated to the different unforced choice formats. We used mixed logit error component models to estimate preferences. Results . We found that the use of different unforced choice formats affects marginal utilities and welfare estimates and hence the conclusions that will be drawn from the DCE to inform health care decision making. Conclusions . To avoid biased estimates, we recommend that researchers are hesitant to use the neither option and consider including a status quo in addition to opt-out in settings where a status quo exists.

Keywords: discrete choice experiment; neither; opt-out; status quo; unforced choice (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X19862275 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:39:y:2019:i:6:p:681-692

DOI: 10.1177/0272989X19862275

Access Statistics for this article

More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().