Fiebig Denzil G, Haas Marion, Hossain Ishrat, Street Deborah J, Viney Rosalie
School of Economics, University of New South Wales, Australia.
Soc Sci Med. 2009 May;68(10):1766-74. doi: 10.1016/j.socscimed.2009.03.002. Epub 2009 Mar 30.
Despite the success internationally of cervical screening programs debate continues about optimal program design. This includes increasing participation rates among under-screened women, reducing unnecessary early re-screening, improving accuracy of and confidence in screening tests, and determining the cost-effectiveness of program parameters, such as type of screening test, screening interval and target group. For all these issues, information about consumer and provider preferences and insight into the potential impact of any change to program design on consumer and provider behaviour are essential inputs into evidence-based health policy decision making. This paper reports the results of discrete choice experiments to investigate women's choices and providers' recommendations in relation to cervical screening in Australia. Separate experiments were conducted with women and general practitioners, with attributes selected to allow for investigation of how women and general practitioners differ in their preferences for attributes of screening programs. Our results indicate a considerable commonality in preferences but the alignment was not complete. Women put relatively more weight on cost, chance of a false positive and if the recommended screening interval were changed to one year.
尽管宫颈癌筛查项目在国际上取得了成功，但关于最佳项目设计的争论仍在继续。这包括提高筛查不足女性的参与率、减少不必要的早期复查、提高筛查测试的准确性和可信度，以及确定项目参数（如筛查测试类型、筛查间隔和目标群体）的成本效益。对于所有这些问题，有关消费者和提供者偏好的信息以及对项目设计的任何变化对消费者和提供者行为的潜在影响的洞察，都是基于证据的卫生政策决策的重要输入。本文报告了离散选择实验的结果，以调查澳大利亚女性在宫颈癌筛查方面的选择以及提供者的建议。对女性和全科医生分别进行了实验，所选属性用于调查女性和全科医生在筛查项目属性偏好上的差异。我们的结果表明偏好上有相当大的共性，但一致性并不完全。女性相对更看重成本、假阳性的可能性以及推荐的筛查间隔是否改为一年。
