Heidenreich Sebastian, Watson Verity, Ryan Mandy, Phimister Euan
Health Economics Research Unit, University of Aberdeen, Aberdeen, UK.
Business School, University of Aberdeen, Aberdeen, UK.
Health Econ. 2018 Jan;27(1):157-171. doi: 10.1002/hec.3524. Epub 2017 Jun 16.
This paper investigates if respondents' choice to not consider all characteristics of a multiattribute health service may represent preferences. Over the last decade, an increasing number of studies account for attribute non-attendance (ANA) when using discrete choice experiments to elicit individuals' preferences. Most studies assume such behaviour is a heuristic and therefore uninformative. This assumption may result in misleading welfare estimates if ANA reflects preferences. This is the first paper to assess if ANA is a heuristic or genuine preference without relying on respondents' self-stated motivation and the first study to explore this question within a health context. Based on findings from cognitive psychology, we expect that familiar respondents are less likely to use a decision heuristic to simplify choices than unfamiliar respondents. We employ a latent class model of discrete choice experiment data concerned with National Health Service managers' preferences for support services that assist with performance concerns. We present quantitative and qualitative evidence that in our study ANA mostly represents preferences. We also show that wrong assumptions about ANA result in inadequate welfare measures that can result in suboptimal policy advice. Future research should proceed with caution when assuming that ANA is a heuristic.
本文探讨了受访者选择不考虑多属性健康服务的所有特征是否可能代表偏好。在过去十年中，越来越多的研究在使用离散选择实验来引出个体偏好时考虑了属性不关注（ANA）情况。大多数研究认为这种行为是一种启发式方法，因此不提供信息。如果ANA反映了偏好，那么这个假设可能会导致误导性的福利估计。本文是第一篇在不依赖受访者自我陈述动机的情况下评估ANA是一种启发式方法还是真实偏好的论文，也是第一篇在健康背景下探讨这个问题的研究。基于认知心理学的研究结果，我们预计熟悉的受访者比不熟悉的受访者更不太可能使用决策启发式方法来简化选择。我们采用了一个离散选择实验数据的潜在类别模型，该模型涉及国民保健制度管理者对有助于解决绩效问题的支持服务的偏好。我们提供了定量和定性证据，表明在我们的研究中，ANA大多代表偏好。我们还表明，对ANA的错误假设会导致福利措施不足，进而可能导致次优的政策建议。在假设ANA是一种启发式方法时，未来的研究应谨慎行事。
