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Preferences for hospital quality in Zambia: results from a discrete choice experiment
Author(s) -
Hanson Kara,
McPake Barbara,
Nakamba Pamela,
Archard Luke
Publication year - 2005
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.959
Subject(s) - socioeconomic status , quality (philosophy) , willingness to pay , actuarial science , medicine , marginal utility , economics , public economics , business , environmental health , microeconomics , population , philosophy , epistemology
This study reports on the results of a discrete choice experiment undertaken in Zambia to assess the factors influencing the demand for hospital care in Zambia, in particular the role of (perceived) quality and trade‐offs between price and quality. Valuations of quality were evaluated for the treatment of two acute medical conditions, cerebral malaria in adults and acute pneumonia in children. Marginal utilities and willingness‐to‐pay for attributes of quality of hospital care were estimated, together with the influence of socioeconomic characteristics on these valuations and the extent of non‐linearities in valuations of time and money. We find the technical quality of care, as represented by the thoroughness of examination, to be the most important quality attribute, followed by staff attitudes and drug availability. Valuations of examination thoroughness increase with increasing socioeconomic status. The disutility of cost was found to decrease with higher socioeconomic status, as was the value of drug availability. The implications of the findings for Zambian hospital sector reforms are discussed. Copyright © 2004 John Wiley & Sons, Ltd.