Preferences of Hungarian consumers for quality, access and price attributes of health care services — result of a discrete choice experiment

Abstract

In 2010, a household survey was carried out in Hungary among 1037 respondents to study consumer preferences and willingness to pay for health care services. In this paper, we use the data from the discrete choice experiments included in the survey, to elicit the preferences of health care consumers about the choice of health care providers. Regression analysis is used to estimate the effect of the improvement of service attributes (quality, access, and price) on patients' choice, as well as the 1 The study is financed by the European Commission under the 7th Framework Program, Theme 8 Socioeconomic Sciences and Humanities, Project ASSPRO CEE 2007 (Grant Agreement no. 217431). The content of the publication is the sole responsibility of the authors and it in no way represents the views of the Commission or its services.2 differences among the socio-demographic groups. We also estimate the marginal willingness to pay for the improvement in attribute levels by calculating marginal rates of substitution. The results show that respondents from a village or the capital, with low education and bad health status are more driven by the changes in the price attribute when choosing between health care providers. Respondents value the good skills and reputation of the physician and the attitude of the personnel most, followed by modern equipment and maintenance of the office/hospital. Access attributes (travelling and waiting time) are less important. The method of discrete choice experiment is useful to reveal patients' preferences, and might support the development of an evidence-based and sustainable health policy.

Preferences of Bulgarian consumers for quality, access and price attributes of healthcare services-result of a discrete choice experiment

“…All findings related to the ranking of waiting and traveling time (access‐related attributes) confirm that these attributes are less important for the respondents than the quality‐related attributes. A lower importance of access compared with quality is reported in several studies conducted inside and outside Bulgaria (e.g., Zafirova and Kehaiova, ; Pavlova et al ., ; Baji et al ., ; Bergrath et al ., ). This confirms that individuals are not against traveling and waiting if they receive better quality services.…”

“…Thus, providers' proficiency and specialized care remain highly valued by Bulgarian healthcare consumers. This is similar to other Central and Eastern European countries (Baji et al ., ; Danyliv et al ., ). The enhancement of these attributes should be a priority in Bulgarian health policy strategies.…”

“…With respect to the fee attributes, there is a slight change (reduction) in the importance that Bulgarian consumers attach to this attribute, which can be explained by the improved ability to pay for healthcare. As in previous studies, not only in Bulgaria but also in other European countries (Baji et al ., ; Bergrath et al ., ; Danyliv et al ., ), we find that access‐related attributes (travel and waiting time) are less important to consumers than the fee size and the quality‐related attributes. An exception here is psychological access (staff attitude).…”

“…It is expected that each individual derives unique utility from each attribute level and chooses the profile that maximizes his or her utility. It is supposed that the consumers choose a profile over an alternative profile if the expected utility associated with the first profile is higher than the expected utility associated with the second profile (Baji et al ., ).…”

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“…This is a fundamental issue that needs to be addressed for a successful health care reform (Gaál and al. 2011;Baji and al. 2012).…”