Application of Conjoint Analysis to Preferences of Low *

描述：拟议的研究使用联合分析（CA）得出 HMO腰痛患者对脊椎按摩疗法的偏好， 初级保健访问，因过程和健康结果的属性而异。 通过管理数据识别的研究受试者将收到一封邮件 问卷，其核心是一组10 - 12个假设性的选择 在因结果和过程的特定属性而不同的访问之间， 包括成本。将使用基于以下因素的概率单位回归分析应答： 随机效用理论可靠和可推广的经济评价 补充和替代医学（CAM）疗法，如脊椎按摩疗法 为健康保险公司的资源分配决策提供信息， 付款人。由于CAM的大多数好处是生活质量的改善， 与延长寿命相比，适当的效用估计将至关重要。我们 假设对"过程"评估？实用性将特别 重要的CAM上下文，基于大量的研究表明， 来自CAM的治疗益处（例如，信息（beyond direct） 健康成果。CA可能在经济评估中具有潜在的价值 因为在理论上，它可以产生效用和支付意愿 (WTP)包括过程和最终结果的估计。的 本研究的具体目标是（1）进行联合可行性研究 分析作为一种方法，引起偏好脊椎按摩疗法和 传统治疗急性下腰痛的人群中， 大约有400名Kaiser Permanente Northwest的成年成员被诊断患有 急性腰痛，侧重于有效性和可靠性的评估， 包括回答者负担和内部一致性;（2）产生初步的 包含过程和结果属性的效用估计， 最终用于下背痛治疗的成本效用分析， HMO背景;以及（3）为过程属性生成初步的WTP估计 下背痛治疗的成本效益分析， HMO的背景。这项研究将产生有用的初步数据， 未来发展的效益评估方法，适合于 脊椎指压治疗的经济评估，对这两个过程都很敏感 和结果。我们希望这项研究的经验教训将很容易推广到 未来CAM中其他疗法的经济评价以及 传统医学，特别是在管理式护理环境中提供的传统医学。

DESCRIPTION: The proposed study uses conjoint analysis (CA) to elicit preferences of a sample of HMO low back pain patients for chiropractic and primary care visits that vary by attributes of process and health outcomes. Study subjects identified through administrative data will receive a mail questionnaire, the core of which is a set of 10- 12 hypothetical choices between visits that vary by specified attributes of outcome and process, including cost. Responses will be analyzed using probit regression based on random utility theory. Reliable and generalizable economic evaluations of therapies in complementary and alternative medicine (CAM) such as chiropractic are needed to inform resource allocation decisions of health insurers and payers. Since most benefits from CAM are quality of life improvements rather than life extension, appropriate utility estimates will be crucial. We hypothesize that assessments of "process"? utility will be especially important in the CAM context, based on considerable research suggesting that therapeutic benefits from CAM (e.g., reassurance, information) beyond direct health outcomes. CA may be potentially quite valuable in economic evaluations of CAM because in theory it can produce both utility and willingness to pay (WTP) estimates that incorporate process as well as final outcome. The specific aims of this study are to (1) conduct a feasibility study of conjoint analysis as a method of eliciting preferences over chiropractic and conventional treatment of acute low back pain among a population of approximately 400 adult members of Kaiser Permanente Northwest diagnosed with acute low back pain, focusing on assessments of validity and reliability, including respondent burden and internal consistency; (2) produce preliminary utility estimates that incorporate both process and outcome attributes, for eventual use in cost-utility analyses of low back pain treatment within the HMO context; and (3) produce preliminary WTP estimates for process attributes of low back pain treatment for eventual use in cost-benefit analyses within the HMO context. This study will generate useful preliminary data that informs the future development of benefit assessment methods that are appropriate for economic evaluations of chiropractic and that are sensitive to both process and outcome. We expect that lessons from this study will readily generalize to future economic evaluations of other therapies in CAM as well as in conventional medicine, especially those delivered in the managed care context.