TY - JOUR T1 - Counting the cost of fast access: using discrete choice experiments to elicit preferences in general practice JF - British Journal of General Practice JO - Br J Gen Pract SP - 4 LP - 5 VL - 56 IS - 522 AU - Mandy Ryan AU - Verity Watson Y1 - 2006/01/01 UR - http://bjgp.org/content/56/522/4.abstract N2 - In publicly provided healthcare systems, when limited resources are coupled with unlimited demand, decisions have to be made about the efficient allocation of scarce resources. This raises questions of how services should be provided (for example, should breast cancer patients be prescribed Trastuzumab®? Should there be an increased role for pharmacists in prescribing?) through to the optimal provision and financing of health care (for example, how can we encourage doctors to provide out-of-hours care or work in remote and rural areas?). Trade-offs inevitably have to be made. A technique gaining popularity in health economics to identify trade-offs is the discrete choice experiment approach,1 used by Longo et al2 in this Journal to consider patients' preferences for shared decision-making. Within general practice the technique has been used to elicit patient and community preferences,2–6 as well as to explore GP preferences for job characteristics.7–9Discrete choice experiments are based on the assumptions that interventions, services or policies can be described by characteristics, and that value depends on the levels of these characteristics. Responders are presented with a number of choices that involve different levels of attributes. For each choice they are asked which option they would choose. Making choices involves trade-offs between attribute levels. Responses are analysed using regression techniques and from this it is possible to estimate the relative importance of attributes, as well as the trade-offs between attributes; for example, how much longer individuals are willing to … ER -