Preferences for managing symptoms of differing severity: a discrete choice experiment

Background: To design cost-effective health services it is important to understand why people adopt particular symptom management strategies.

Aim: To establish the relative importance of factors that influence decision making when managing symptoms of differing severity, to establish how people trade between these factors, and to estimate the monetary value placed on different management types.

Design: Discrete choice experiment.

Setting: UK online research panel.

Method: Successive members of an online panel were invited to participate until 480 discrete choice experiment questionnaires were completed. Relative preferences for managing three symptom scenarios of varying severity were measured. Symptom management was described by three characteristics (management type, availability, and cost). Preferences for ways of managing symptoms were measured by using conditional logit analysis.

Results: A total of 98.5% of the completed questionnaires were valid (473 of 480 respondents). People preferred to manage minor symptoms by self-care or by visiting a pharmacy and were willing to pay £21.58 and £19.06, respectively, to do so. For managing moderately severe symptoms, people preferred to consult a general practitioner and were willing to pay £34.86 for this option. People preferred to manage potentially very severe symptoms by consulting a general practitioner and were willing to pay £73.08 to do so. Respondents were willing to trade between management types; options less preferred became more attractive when waiting time and cost were reduced.

Conclusion: People value self-care, supported self-care, and general practitioner consultation differently depending on the type of symptoms. Manipulating costs to users and waiting times for different services could allow policymakers to influence the services people choose when managing symptoms.