PhD: Elicitation and application of preference values in economics evaluation: case studies in reproductive health
Application of the standard methods of cost–utility analysis can be challenging in maternal and reproductive healthcare because: (1) alternative interventions can be geared towards enhancing the experience of women, rather than improving health status; and (2) alternative interventions can directly affect the health and well-being of both the woman and infant(s).
This thesis discusses and attempts to address these challenges through three empirical case studies. The first demonstrates a method for measuring and incorporating women’s preferences for patient experience factors into an economic evaluation comparing alternative approaches to labour management. The second assesses women’s preferences for mother-infant health outcomes in the context of an economic evaluation comparing alternative approaches to IVF treatment. The final case study adopts an approach to estimate the relative monetary value that community members place on the prevention of maternal and neonatal deaths, in the context of decisions between competing healthcare programmes that impact differentially on these outcomes.
Outcome and translation
The case studies show that the challenges identified above can be overcome by adapting one or other of the stated preference valuation techniques available to health economists. DCEs in particular offer a flexible approach to dealing with the complexities and trade-offs that can arise when considering choices between alternative reproductive healthcare interventions in the context of scarce resources.
PhD Student: Graham Scotland
Supervisors: Mandy Ryan, Paul McNamee, Marjon van der Pol. (HERU), D Newlands (Economics, University of Aberdeen Business School); J Hussein (Division of Applied Health Sciences, University of Aberdeen)
Scotland, G. (2010) 'Elicitation and application of preference values in economics evaluation: case studies in reproductive health', PhD thesis, University of Aberdeen.
Scotland, G., McLernon, D., Kurinczuk, J.J., McNamee, P., Harrild, K., Lyall, H., Rajkhowa, M., Hamilton, M. and Bhattacharya, S. (2011) 'Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost–utility of elective single versus double embryo transfer over a 20-year time horizon', BJOG: An International Journal of Obstetrics & Gynaecology, 118(9), 1073--1083.
Scotland, G., McNamee, P., Cheyne, H., Hundley, V. and Barnett, C. (2011) 'Women's preferences for aspects of labor management: results from a discrete choice experiment', Birth-Issues in Perinatal Care, 38(1), 36-46.
Scotland, G., McNamee, P.,Peddie, V., Bhattacharya, S. (2006) ‘Safety versus success in SET: women’s preferences for outcomes of IVF’, 22nd Annual Meeting of the European Society for Human Reproduction and Embryology, Prague, June 2006 (Human Reproduction 2006; 21(Supplement1): i81, O-205).
Cheyne, H., Hundley, V., Dowding, D., Aucott, L., McNamee, P., Styles, M., Barnett, C.A., Greer, I., Bland, M., Niven, K., McNamee, P., Scotland, G. (2008) ‘Measuring the benefits of an algorithm for diagnosis of active labour: results from a discrete choice experiment (DCE). The Early Labour Study in Scotland (TELSiS).’ Symposium at the 28th Congress of the International Confederation of Midwives, Glasgow, June 2008.
Scotland, G., Mclernon, D., Kurinczuk, J.J., Jamieson, M., Lyall, H., Rajkhowa, M., Harrold, A. and Bhattacharya, S. (2010) 'Avoiding twins in IVF: the cost-effectiveness and cost-utility of elective single and double embryo transfer over a 20 year time horizon', Annual Meeting of the European Society for Human Reproduction and Embryology, Rome, Italy, June 2010.