Cook Alex R, Zhao Xiahong, Chen Mark I C, Finkelstein Eric A
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
Program in Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore.
BMJ Open. 2018 Feb 16;8(2):e017355. doi: 10.1136/bmjopen-2017-017355.
When faced with an emergent epidemic with high mortality and morbidity potential, policy makers must decide what public health interventions to deploy at different stages of the outbreak. However, almost nothing is known about how the public view these interventions or how they trade off risks (of disease) with inconvenience (of interventions). In this paper, we aim to understand public perceptions on pandemic interventions, as well as to identify if there are any distinct respondent preference classes.
A discrete choice experiment.
This study was fielded in Singapore between November 2012 and February 2013.
A random sample of 500 Singapore residents aged 21 and over, including 271 women and 229 men, was analysed.
Demographic information was collected from each participant. Participants were also shown a series of pairs of alternatives, each combining interventions and morbidity, mortality and cost outcomes and declared a preference for one combination. A random utility model was developed to determine the individual's preference for interventions and a hierarchical cluster analysis was performed to identify distinct respondent preference classes.
On average, participants preferred more intense interventions, and preferred scenarios with fewer deaths and lower tax. The number of infections did not significantly influence respondents' responses. We identified two broad classes of respondents: those who were mortality averse and those who were expenditure averse. Education was found to be a predictor of group membership.
Overall, there was considerable support for government interventions to prevent or mitigate outbreaks of emerging infectious diseases, including those that greatly restricted individual liberties, as long as the restrictions showed a reasonable chance of reducing the adverse health effects of the outbreak.
面对具有高致死率和高发病率潜在风险的突发疫情时，政策制定者必须决定在疫情爆发的不同阶段采取何种公共卫生干预措施。然而，对于公众如何看待这些干预措施，以及他们如何权衡疾病风险与干预带来的不便，几乎一无所知。在本文中，我们旨在了解公众对大流行干预措施的看法，并确定是否存在不同的受访者偏好类别。
离散选择实验。
本研究于2012年11月至2013年2月在新加坡进行。
对500名年龄在21岁及以上的新加坡居民进行随机抽样分析，其中包括271名女性和229名男性。
收集每位参与者的人口统计学信息。还向参与者展示了一系列成对的备选方案，每个方案都结合了干预措施以及发病率、死亡率和成本结果，并让他们表明对其中一种组合的偏好。开发了一个随机效用模型来确定个体对干预措施的偏好，并进行层次聚类分析以识别不同的受访者偏好类别。
平均而言，参与者更喜欢更严格的干预措施，并且更喜欢死亡人数较少和税收较低的数据。感染人数对受访者的反应没有显著影响。我们确定了两大类受访者：厌恶死亡的人和厌恶支出的人。研究发现教育程度是群体归属的一个预测因素。
总体而言，只要这些限制措施有合理的机会减少疫情对健康的不利影响，政府为预防或减轻新兴传染病爆发而采取的干预措施，包括那些极大限制个人自由的措施，得到了相当多的支持。
