USING DISCRETE CHOICE EXPERIMENT MODELLING TO ASSESS PREFERENCES FOR HEALTH SYSTEM CHARACTERISTICS IN THE UNITED KINGDOWM AND AUSTRALIA

OBJECTIVES: Comparisons are often made between the performances of different countries’ health care systems. In 2000, the World Health Organisation (WHO) attempted to measure the performance of health systems of 191 countries and to create league tables of good and bad performers.  However, a major assumption of the WHO research was that the general public had the same preferences for health care system attributes, no matter which country they were based.  Our study aims to provide a pilot study to evaluate the public health preferences of citizens of the UK and Australia. METHODS: Eight attributes were carefully selected to convey information about a health care system. These included: life expectancy, infant mortality rates, waiting times, degree of choice, direct access to specialist, level of information provided and degree of funding from the public.  A discrete choice experiment approach was used to model to preferences of the individuals. RESULTS: All characteristics affected the likelihood a health system would be preferred, with the exception of the additional tax contribution levels required to finance the system.  The Australian sample was generally willing to forgo a greater number of years of life expectancy for gains related to responsiveness; whilst, the UK sample was willing to forgo a greater number of years for equity gains. CONCLUSIONS: The preliminary findings of this pilot study suggest some consistency between the health system preferences of two samples selected from the UK and Australia.  However, they also provide some indication that health system exposure may affect the strength of preferences surrounding the attributes that individuals consider to be important for their preferred health system.